Alexander Brian Gutierrez Marquez, MD

Individual provider Active NPI Family Medicine Physician · Little Rock Afb, AR

NPI 1780104240 · NPPES record last updated Jul 10, 2024

Key facts

NPI
1780104240
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
31437 (NE)
Practice address
1090 Arnold Dr
Little Rock Afb, AR 72099-4933
Phone
(501) 987-7319
NPI assigned
Jun 26, 2017
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20170818001271 NV Order and Referring Only - Family Practice
Practitioner - Family Practice
0749552297

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31437NEMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 31437 NE Yes

Addresses

Primary practice location

1090 Arnold Dr
Little Rock Afb, AR 72099-4933

Mailing address

1090 Arnold Dr
Little Rock Afb, AR 72099-4933
Phone (501) 987-7319

Other names

  • Alex Gutierrez Marquez Other name

Other providers in Little Rock Afb, AR

All providers in Little Rock Afb, AR · Family Medicine Physician in Arkansas

Sources for this page

Verify at the official NPI Registry.