Healthcare Provider Details

I. General information

NPI: 1093510760
Provider Name (Legal Business Name): DEREK GILILLAND DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 S HORSEBARN RD STE 101
ROGERS AR
72758-8797
US

IV. Provider business mailing address

593 S HORSEBARN RD STE 101
ROGERS AR
72758-8797
US

V. Phone/Fax

Practice location:
  • Phone: 888-450-9191
  • Fax:
Mailing address:
  • Phone: 888-450-9191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number16290
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: