Individual
DR. ROBERT R GULLETT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1125 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1908
(479) 521-8260
(479) 443-3903
Mailing address
1125 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1908
(479) 521-8260
(479) 443-3903
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
R2352
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102963001
—
AR
Enumeration date
08/31/2006
Last updated
02/24/2010
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