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NPI Code Detail

MEDICARE: DR. GAYATHRI BHAGWATH M.D.

MEDICARE: DR. GAYATHRI BHAGWATH M.D.
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
1207RX0202XMedical Oncology PhysicianM5053TX
2207R00000XInternal Medicine PhysicianM5053TX

General Provider Information

NPI Number : 1760488290
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GAYATHRI BHAGWATH M.D.
Provider Business Mailing Address
First Line : 1100 N COLLEGE AVE
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-1944
Country : US
Telephone Number : 479-587-5971
Fax Number :
Provider Business Practice Location Address
First Line : 1100 N COLLEGE AVE
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-1944
Country : US
Telephone Number : 479-587-5971
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 09/10/2025

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