Gresham, Edward A
Gresham, Edward A is an individual health care provider with primary practice located at 909 Unity Rd , Crossett AR 71635-9444. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gresham, Edward A can be contacted via phone (870) 364-9111.Contact Information
Primary practice address
909 Unity Rd
Crossett AR 71635-9444
Phone: (870) 364-9111
Fax: (870) 364-5581
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | G5569 | Arkansas |
Profile Details
| NPI number | 1346220688 |
|---|---|
| LBN Legal business name | Gresham, Edward A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 20th, 2006 |
| Last updated | Feb 8th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346220688 | NPPES |
| Arkansas | MEDICAID | 104845001 | |
| Arkansas | Other | 15181 |
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