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Contact Information

COOPER CLINIC PA
6801 ROGERS AVE
FORT SMITH, AR72903-4067
 Phone: 479-274-3500
 Fax: 479-274-3599
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for COOPER CLINIC PA

NPI Number 1700099074
LBN Legal business name COOPER CLINIC PA
Authorized official CURTIS RALSTON - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 05/07/2007
Last updated 09/01/2015 - About 11 years ago
Identifiers
AR License # MC-0254
AR Medicaid 125018002
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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