Healthcare Provider Details
I. General information
NPI: 1992715700
Provider Name (Legal Business Name): PETER W. GURESKY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/08/2006
Last Update Date: 03/17/2020
Certification Date: 03/17/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
105 BAY RIDGE LOOP
HOT SPRINGS AR
71901-9272
US
IV. Provider business mailing address
PO BOX 2365
HOT SPRINGS AR
71914-2365
US
V. Phone/Fax
- Phone: 501-262-2047
- Fax:
- Phone: 501-624-7111
- Fax: 501-262-0335
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | C-7700 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: