Unknown Individual – Family Medicine Physician, NPI 1295770261

Unknown Individual is a healthcare provider. based in Fort smith, Arkansas. specializing in Family Medicine Physician. They hold a License No. R4008 (AR). The NPI Number for Unknown Individual is 1295770261

Main info

Organization
Inactive
50 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1295770261
Phone
(479) 314-1131
Address
PO BOX 17000
Deactivation Date
23 August 2023

Doctor Profile

Medical School Name
UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
Secondary Phone
4796674138
Graduation Year
1976 (50 years ago)
PAC ID
4385629658
Group Practice PAC ID
3678467412
Professional Enrollment ID
I20040621001609
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • PO BOX 17000

    FORT SMITH, AR 729177000

    Phone: (479) 314-1131

    Fax: (479) 314-1194

    Type: Mailing

  • Mercy Hospital Ozark, 801, West River Street, Ozark, Franklin County, Arkansas, 72949, United States

    OZARK, AR 729493023

    Phone: (479) 314-1131

    Fax: (479) 314-1194

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 72917)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3678467412View full group profile
NameSpecialtyState
General SurgeryAR
Emergency MedicineAR
Family PracticeOK
Family PracticeAR
Emergency MedicineIL
-AR
-AR
Family PracticeAR
Family PracticeAR
Family PracticeAR

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1295770261 — is the standard way to identify this listing.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Fort Smith, Arkansas in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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