Gustavus, John L.
Gustavus, John L. is an individual health care provider with primary practice located at 7418 North Hills Blvd , North Little Rock AR 72116-7026. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gustavus, John L. can be contacted via phone (501) 833-0177.Contact Information
Primary practice address
7418 North Hills Blvd
North Little Rock AR 72116-7026
Phone: (501) 833-0177
Fax: (501) 833-0223
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | C4200 | Arkansas |
Profile Details
| NPI number | 1770559635 |
|---|---|
| LBN Legal business name | Gustavus, John L. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 28th, 2006 |
| Last updated | Oct 7th, 2008 - about 16 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 | 1770559635 | NPPES |
| Arkansas | MEDICAID | 106636001 | |
| Arkansas | Other | C-4200 |
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