Organization
KENNETH E. GARDNER, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH E. GARDNER M.D. (PRESIDENT)
(479) 314-7545
Entity
Organization
Contact information
Practice address
7301 ROGERS AVE, FORT SMITH, AR 72903-4100
(479) 314-7545
(479) 484-1640
Mailing address
7301 ROGERS AVE, FORT SMITH, AR 72903-4100
(479) 314-7545
(479) 484-1640
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C-6152
AR
Other
Enumeration date
12/29/2005
Last updated
08/22/2020
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