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General NPI Number Information
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NPI Number | 1386608636
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Entity Type | Organization
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Legal Business Name | GYNECOLOGIC ONCOLOGY OF ARKANSAS
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9501 LILE DR STE 777
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City | LITTLE ROCK
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State | AR
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Zip | 72205-6232
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Country | US
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Telephone | 501-228-7779
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Fax | 501-228-7877
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Provider Business Mailing Address
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Address Line | 9501 LILE DR STE 777
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City | LITTLE ROCK
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State | AR
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Zip | 72205-6232
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Country | US
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Telephone | 501-228-7779
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Fax | 501-228-7877
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID SAYRE BARD
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Credential | MD
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Telephone | 501-228-7779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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