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General NPI Number Information
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NPI Number | 1518245828
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Entity Type | Individual
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Provider Name | ANIL V GAJARE MD
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Gender | Male
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Dates
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Enumeration Date | 08/03/2011
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Last Update Date | 03/22/2018
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Provider Practice Location Address
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Address Line | 2601 GENE GEORGE BLVD
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City | SPRINGDALE
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State | AR
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Zip | 72762-0845
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Country | US
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Telephone | 479-725-6801
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Fax | 479-725-6577
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Provider Business Mailing Address
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Address Line | 1 CHILDRENS WAY # 844
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City | LITTLE ROCK
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State | AR
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Zip | 72202-3500
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Country | US
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Telephone | 501-364-2090
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Fax | 501-364-3929
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | Q1150
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 018864
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | E-11028
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License Number State | AR
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