Elders, John Gregory
Elders, John Gregory is an sole proprietor health care provider with primary practice located at 630 Burnett Dr , Mountain Home AR 72653-2941. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Elders, John Gregory can be contacted via phone (870) 425-6971.Contact Information
Primary practice address
630 Burnett Dr
Mountain Home AR 72653-2941
Phone: (870) 425-6971
Fax: (870) 508-8900
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | C7687 | Arkansas |
Profile Details
| NPI number | 1174520688 |
|---|---|
| LBN Legal business name | Elders, John Gregory |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 30th, 2005 |
| Last updated | Apr 27th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174520688 | NPPES |
| Arkansas | MEDICAID | 121500001 | |
| Arkansas | Other | 080035552 |
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