Healthcare Provider Details
I. General information
NPI: 1538357470
Provider Name (Legal Business Name): DEVI GOPINATH NAIR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/04/2007
Last Update Date: 11/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
201 E OAK AVE
JONESBORO AR
72401-4163
US
IV. Provider business mailing address
201 E OAK AVE
JONESBORO AR
72401-4163
US
V. Phone/Fax
- Phone: 870-935-6729
- Fax: 870-268-4478
- Phone: 870-935-6729
- Fax: 870-268-4478
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0001X |
| Taxonomy | Clinical Cardiac Electrophysiology Physician |
| License Number | E-6916 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: