Sovereign Force, PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

MC-2586 Issued in AR

Legal business name

SOVEREIGN FORCE, PA

Doing business as

The Clinic at Commerce Centre

Practice address

301 SW 16TH St
Bentonville, AR 72712-7173

Phone

(479) 586-9800

NPI assigned

Dec 28, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ajdahan D. Bicak, M.D.NPI 1316904865

Title

President

Phone

(479) 586-9800

Specialties & licenses 1

Addresses

Other names 1

• The Clinic at Commerce Centre Doing business as

Locations

Practitioners 1

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

• Ajdahan Deniz Bicak, M.D.

  • Family Medicine Physician
  • Bentonville, AR
  • NPI 1316904865
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1629252440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SW 16TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127173",
            "telephone_number": "479-586-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SW 16TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127173",
            "telephone_number": "479-586-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN FORCE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-28",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "BICAK",
        "authorized_official_first_name": "AJDAHAN",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-586-9800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AR",
            "license": "MC-2586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Clinic at Commerce Centre",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Arkansas Emergency Physicians, LLP
• South Central Hospitalists, LLP
• Leila Wade South
• Southern Caregivers of Bentonville LLC
• Jared Souza, MHPP
• Autumn Spainhour
• Gregory Ryan Spears, D.O.
• Mark Alan Spears Jr., APRN
• Ashley Spencer, PT, DPT
• Chelsea Spencer

• Primary Care Clinic/Center in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Primary Care Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.