Mecum, Gideon S

Mecum, Gideon S is an individual health care provider with primary practice located at 3215 N. North Hill Drive , Fayetteville AR 72703-4424. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Mecum, Gideon S can be contacted via phone (479) 463-7102.

Contact Information

Primary practice address
3215 N. North Hill Drive Fayetteville AR 72703-4424
Fax: (479) 463-7864
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 207PP0204X E-6020 Arkansas
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X E-6020 Arkansas
Allopathic & Osteopathic Physicians / Pediatrics 208000000X E-6020 Arkansas

Profile Details

NPI number 1710106042
LBN Legal business name Mecum, Gideon S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2007
Last updated Feb 18th, 2019 - 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 1710106042 NPPES
Arkansas MEDICAID 177619001

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