Individual
GERALD S STIPANUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1007 WINDOVER RD # 6009, JONESBORO, AR 72401-6007
(870) 520-6473
Mailing address
1007 WINDOVER RD # 6009, JONESBORO, AR 72401-6007
(870) 204-0534
(731) 235-0559
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
29939
TN
207R00000X
Internal Medicine Physician
Primary
E-7145
AR
207R00000X
Internal Medicine Physician
TPME2910
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000006613645
BCBS KY
KY
05
—
1511734
—
TN
01
—
4217156
BCBS TN
TN
Enumeration date
12/28/2005
Last updated
04/06/2026
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