Organization Name: | COOPER CLINIC, PA |
NPI Number: | 1740201474 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CURTIS D RALSTON (CEO) |
Mailing Address: | 9101 Jenny Lind Rd Fort Smith |
State: | AR US |
Postal Code: | 729089142 |
Phone Number: | 4792746000 |
Fax Number: | 4794844792 |
NPI Enumeration Date: | 07/21/2006 |
NPI Last Update Date: | 09/01/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261Q00000X |
License Number: | MC-0254 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |