MEDICARE: CECIL W GABY MD PA

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
1	173000000X	Legal Medicine	MC-2382	AR

General Provider Information

NPI Number	:	1588676571
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CECIL W GABY MD PA

Provider Business Mailing Address
First Line	:	7303 ROGERS AVE
Second Line	:	SUITE 101
City	:	FORT SMITH
State	:	AR
Zip	:	72903-4165
Country	:	US
Telephone Number	:	479-452-7447
Fax Number	:	479-452-6693

Provider Business Practice Location Address
First Line	:	7303 ROGERS AVE
Second Line	:	SUITE 101
City	:	FORT SMITH
State	:	AR
Zip	:	72903-4165
Country	:	US
Telephone Number	:	479-452-7447
Fax Number	:	479-452-6693

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. MELLNIE ANN GABY
Credential	:
Telephone Number	:	479-452-7447

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	07/20/2007

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