| NPI | 1003753757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY TALLEY Controller 479-229-6191 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology |
| 208600000X Surgery | |
| Enumeration Date | 2026-04-30 |
| Last Update Date | 2026-04-30 |