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Organization

ARKANSAS GATEWOOD EMERGENCY ROOM SERVICES, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH H GATEWOOD MD (PRESIDENT)
(214) 712-2000
Entity
Organization

Contact information

Practice address
3215 N NORTHHILLS BLVD, FAYETTEVILLE, AR 72703-4007
(479) 713-1000
(214) 712-2487
Mailing address
1717 MAIN ST, SUITE 5200, DALLAS, TX 75201-4605
(214) 712-2000
(214) 712-2487

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5F264
BLUE SHIELD
AR
Enumeration date
05/19/2006
Last updated
04/20/2008
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