Individual
PHILLIP THOMAS GULLIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2180 ADA AVENUE, SUITE 300, CONWAY, AR 72034-7203
(501) 327-6547
(501) 327-9715
Mailing address
2519 COLLEGE AVENUE, CONWAY, AR 72034-6135
(501) 327-6547
(501) 327-9715
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
E 1631
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134193001
—
AR
Enumeration date
02/06/2006
Last updated
03/07/2023
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