Healthcare Provider Details

I. General information

NPI: 1295752368
Provider Name (Legal Business Name): GARY P GEHRKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: GARY P GEHRKI MD

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 11/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 TWIN RIVERS DR STE 101B
ARKADELPHIA AR
71923-4226
US

IV. Provider business mailing address

2850 TWIN RIVERS DR STE 101B
ARKADELPHIA AR
71923-4226
US

V. Phone/Fax

Practice location:
  • Phone: 870-246-8034
  • Fax: 870-246-3536
Mailing address:
  • Phone: 870-246-8034
  • Fax: 870-246-3536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC5914
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: