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Contact Information

COOPER CLINIC PA
600 S 21ST ST
FORT SMITH, AR72901-3915
 Phone: 479-274-6750
 Fax: 479-434-5395
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for COOPER CLINIC PA

NPI # 1710214010
LBN Legal business name COOPER CLINIC PA
Authorized official CURTIS RALSTON - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 11/06/2009
Last updated 09/01/2015 - About 11 years ago
Identifiers
AR License # MC-0254
AR Medicaid 191274716
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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