Individual
GARRY M MELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
620 N WILLOW ST, HARRISON, AR 72601-2994
(570) 424-7070
(870) 424-6616
Mailing address
PO BOX 432, MOUNTAIN HOME, AR 72654-0432
(870) 424-7070
(870) 424-6616
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C00178
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101294701
—
AR
Enumeration date
06/06/2006
Last updated
04/23/2008
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