Individual
DR. JOHN L. GUSTAVUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7418 NORTH HILLS BLVD, NORTH LITTLE ROCK, AR 72116-7026
(501) 833-0177
(501) 833-0223
Mailing address
7418 NORTH HILLS BLVD, NORTH LITTLE ROCK, AR 72116-7026
(501) 833-0177
(501) 833-0223
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C4200
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106636001
—
AR
01
—
C-4200
AR. MEDICIAL LICENSE NUMB
AR
Enumeration date
02/28/2006
Last updated
10/07/2008
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