# KID GLOVES SURGICAL SPECIALISTS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205687217
- **Authorized official:** DR. MARCENE R MCVAY GILLAM MD (OWNER/MANAGER)
- **Authorized official phone:** (501) 349-3182

## Contact information

- **Practice address:** 3623 JOHNSON MILL BLVD STE 101, SPRINGDALE, AR 72762-6412
- **Practice address phone:** (501) 349-3182
- **Mailing address:** PO BOX 6908, SPRINGDALE, AR 72766-6908

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0120X | Pediatric Surgery Physician | — | NULL | Yes |
| 2086S0120X | Pediatric Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/28/2024
- **Last updated:** 03/28/2024