Healthcare Provider Details

I. General information

NPI: 1285262899
Provider Name (Legal Business Name): JONATHON GURULE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 S MAIN ST
JONESBORO AR
72401-3503
US

IV. Provider business mailing address

1010 S MAIN ST
JONESBORO AR
72401-3503
US

V. Phone/Fax

Practice location:
  • Phone: 870-932-1820
  • Fax:
Mailing address:
  • Phone: 870-932-1820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberE-20964
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: