Provider Demographics
NPI:1205655008
Name:TOTAL WOUND CARE OF ARKANSAS,LLC
Entity type:Organization
Organization Name:TOTAL WOUND CARE OF ARKANSAS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-659-6993
Mailing Address - Street 1:1900 NW EXPRESSWAY STE 800
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-1804
Mailing Address - Country:US
Mailing Address - Phone:405-246-0811
Mailing Address - Fax:405-546-5801
Practice Address - Street 1:4250 N VENETIAN LN
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-5077
Practice Address - Country:US
Practice Address - Phone:405-246-0811
Practice Address - Fax:405-546-5801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-08
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty