Barry Gann

Individual provider Active NPI Case Manager/Care Coordinator · Ash Flat, AR

NPI 1376882597 · NPPES record last updated May 15, 2018

Key facts

NPI
1376882597
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
75 Highway 62 412 Ste J
Ash Flat, AR 72513-9629
Phone
(870) 994-7060
Fax
(870) 996-7063
NPI assigned
Feb 7, 2013
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes
Case Manager/Care Coordinator 171M00000X AR

Addresses

Primary practice location

75 Highway 62 412 Ste J
Ash Flat, AR 72513-9629

Mailing address

1815 Pleasant Grove Rd
Jonesboro, AR 72401-7870
Phone (870) 933-6886

Other identifiers

IdentifierTypeStateIssuer
195507795MedicaidAR

Other providers in Ash Flat, AR

All providers in Ash Flat, AR · Case Manager/Care Coordinator in Arkansas

Sources for this page

Verify at the official NPI Registry.