Gibbs, Mark R

Gibbs, Mark R is an individual health care provider with primary practice located at 9500 Kanis Rd Ste 501, Little Rock AR 72205. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Gibbs, Mark R can be contacted via phone (501) 227-9080.

Contact Information

Primary practice address
9500 Kanis Rd Ste 501 Little Rock AR 72205
Fax: (501) 227-0410
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X C5967 Arkansas

Profile Details

NPI number 1366494130
LBN Legal business name Gibbs, Mark R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Jun 23rd, 2010 - about 14 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 1366494130 NPPES
Arkansas MEDICAID 112248001

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