Individual
DR. GARY S EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9616 ROGERS AVE, FORT SMITH, AR 72903-5769
(479) 242-8218
(479) 242-8223
Mailing address
9616 ROGERS AVE, FORT SMITH, AR 72903-5769
(479) 242-8218
(479) 242-8223
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R-3105
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080060546
RR MEDICARE
—
05
—
105874003
—
AR
Enumeration date
07/12/2006
Last updated
03/31/2015
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