Individual
ORNETTE L GAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1233 W POPLAR ST, ROGERS, AR 72756-4245
(479) 751-7417
(479) 751-4898
Mailing address
614 E EMMA AVE, SUITE 300, SPRINGDALE, AR 72764-4634
(479) 751-7417
(479) 751-4898
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-4274
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05070027700
QUAL CHOICE
AR
05
—
158174001
—
AR
01
—
5N255
BCBS
AR
Enumeration date
03/17/2006
Last updated
11/10/2011
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