Gentry, Nicholas L

Gentry, Nicholas L is an individual health care provider with primary practice located at 3959 N. Steele Blvd, Ste 122 , Fayetteville AR 72703. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Gentry, Nicholas L can be contacted via phone (479) 335-5777.

Contact Information

Primary practice address
3959 N. Steele Blvd, Ste 122 Fayetteville AR 72703
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 0101245142 Virginia

Profile Details

NPI number 1497953079
LBN Legal business name Gentry, Nicholas L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2007
Last updated Jul 12th, 2021 - about 5 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 1497953079 NPPES
Other 12518279 CAQH

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