Individual
SUMANTH BALGURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, FAAFP
Contact information
Practice address
7301 ROGERS AVE, FORT SMITH, AR 72903-4100
(479) 314-6030
(479) 314-2021
Mailing address
7301 ROGERS AVE, FORT SMITH, AR 72903-4100
(479) 314-6030
(479) 314-2021
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
27769
OK
207Q00000X
Family Medicine Physician
288945
NY
207Q00000X
Family Medicine Physician
Primary
E-8115
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
198945001
—
AR
Enumeration date
07/06/2010
Last updated
07/10/2023
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