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NPI Code Detail

MEDICARE: MR. JAMES GATTIS APN

MEDICARE: MR. JAMES GATTIS APN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0808XPsychiatric/Mental Health Registered Nurse49985AR
2363LP0808XPsychiatric/Mental Health Nurse PractitionerA03502ANPAR

General Provider Information

NPI Number : 1407878564
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAMES GATTIS APN
Provider Business Mailing Address
First Line : PO BOX 23070
Second Line :
City : BARLING
State : AR
Zip : 72923-0070
Country : US
Telephone Number : 479-452-5040
Fax Number : 479-452-5847
Provider Business Practice Location Address
First Line : 7217 CAMERON PARK DR
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-6167
Country : US
Telephone Number : 479-831-6007
Fax Number : 479-782-1242
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2006
Last Update Date : 10/10/2019

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