Provider Demographics
NPI:1033161146
Name:KRULIN, GREGORY STANLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:STANLEY
Last Name:KRULIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11300 FINANCIAL CENTRE PKWY
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3746
Mailing Address - Country:US
Mailing Address - Phone:501-526-6090
Mailing Address - Fax:501-526-5503
Practice Address - Street 1:11300 FINANCIAL CENTRE PKWY
Practice Address - Street 2:SUITE 1200
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3746
Practice Address - Country:US
Practice Address - Phone:501-526-6090
Practice Address - Fax:501-526-5503
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-48402084S0012X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR103641001Medicaid
AR52993Medicare PIN
AR103641001Medicaid