Individual
ROGER DEAN GILLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2508 CRESTWOOD RD, NORTH LITTLE ROCK, AR 72116-7623
(501) 758-2294
(501) 758-7877
Mailing address
11001 EXECUTIVE CENTER DR STE 200, LITTLE ROCK, AR 72211-4393
(501) 758-2294
(501) 758-7877
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-17057
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2021
Last updated
01/08/2025
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