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NPI Code Detail

MEDICARE: DR. GARY M. NASH JR. M.D.

MEDICARE: DR. GARY M. NASH JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease PhysicianE-9183AR

General Provider Information

NPI Number : 1326274952
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARY M. NASH JR. M.D.
Provider Business Mailing Address
First Line : 7 SHACKLEFORD WEST BLVD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72211-3886
Country : US
Telephone Number : 501-664-5860
Fax Number :
Provider Business Practice Location Address
First Line : 7 SHACKLEFORD WEST BLVD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72211-3886
Country : US
Telephone Number : 501-664-5860
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2009
Last Update Date : 10/13/2016

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