| Cooper Clinic, Pa | |
|
20 N Aster St Greenwood AR 72936-3145 | |
| (479) 996-4111 | |
| (479) 484-4793 |
| Full Name | Cooper Clinic, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 20 N Aster St, Greenwood, Arkansas |
| Authorized Official Name and Position | Curtis D Ralston (CEO) |
| Authorized Official Contact | 4792742000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cooper Clinic, Pa Po Box 3528 Fort Smith AR 72913-3528 Ph: (479) 274-2000 | Cooper Clinic, Pa 20 N Aster St Greenwood AR 72936-3145 Ph: (479) 996-4111 |
| NPI Number | 1235151960 |
|---|---|
| Provider Enumeration Date | 07/24/2006 |
| Last Update Date | 09/01/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235151960 | NPI | - | NPPES |
| 125017002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MC-0254 (Arkansas) | Primary |
Ft Smith Hma Pbc Management, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1480 W Center St, Greenwood, AR 72936 Phone: 479-996-5585 Fax: 479-996-5386 |