Gaines, Ornette L

Gaines, Ornette L is an individual health care provider with primary practice located at 1233 W Poplar St , Rogers AR 72756-4245. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gaines, Ornette L can be contacted via phone (479) 751-7417.

Contact Information

Primary practice address
1233 W Poplar St Rogers AR 72756-4245
Phone: (479) 751-7417
Fax: (479) 751-4898
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X E-4274 Arkansas

Profile Details

NPI number 1386613503
LBN Legal business name Gaines, Ornette L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2006
Last updated Nov 10th, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386613503 NPPES
Arkansas MEDICAID 158174001
Arkansas Other 05070027700
Arkansas Other 5N255

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