Arkansas Foot & Ankle Clinic, PA

Organization Active NPI Foot & Ankle Surgery Podiatrist · Pine Bluff, AR

NPI 1346534047 · NPPES record last updated Oct 10, 2024

Key facts

NPI
1346534047
Entity type
Organization (NPI type 2)
Primary specialty
Foot & Ankle Surgery Podiatrist 213ES0103X
License
162 (AR)
Legal business name
ARKANSAS FOOT & ANKLE CLINIC, PA
Practice address
1801 W 40TH Ave
Suite 4E
Pine Bluff, AR 71603-6940
Phone
(870) 535-4850
Fax
(870) 535-3558
NPI assigned
May 31, 2011
Organization subpart
No

Authorized official

Name
Dr. John P Thrash NPI 1811973225
Title
Doctor
Phone
(870) 535-4850

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20110613000787 AR Part B Supplier - Clinic/Group Practice 3274710587 Receives reassigned benefits from 1 practitioner
Practice locations: Pine Bluff, AR

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist
Group: 193400000X SINGLE SPECIALTY GROUP
213ES0103X 162 AR Yes

Addresses

Primary practice location

1801 W 40TH Ave
Suite 4E
Pine Bluff, AR 71603-6940

Mailing address

1801 W 40TH Ave
Suite 4E
Pine Bluff, AR 71603-6940
Phone (870) 535-4850

Other identifiers

IdentifierTypeStateIssuer
5T328OtherARBLUE CROSS AND BLUE SHIELD
17389000000OtherARQUAL CHOICE
2720022OtherARUNITED HEALTHCARE
480021446OtherARPALMETTO
4249008OtherARAETNA
130021717MedicaidAR

Other names

  • Bryant Foot & Ankle Clinic Doing business as
  • South Arkansas Foot & Ankle Clinic Doing business as

Other providers in Pine Bluff, AR

All providers in Pine Bluff, AR · Foot & Ankle Surgery Podiatrist in Arkansas

Sources for this page

Verify at the official NPI Registry.