Provider Demographics
NPI:1245232768
Name:GOJER, BERNARD (MD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:
Last Name:GOJER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 UNITED DR
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-7826
Mailing Address - Country:US
Mailing Address - Phone:501-358-6361
Mailing Address - Fax:501-358-6714
Practice Address - Street 1:615 UNITED DR
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-7826
Practice Address - Country:US
Practice Address - Phone:501-358-6361
Practice Address - Fax:501-358-6714
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3317207R00000X, 207RC0000X, 207RI0011X, 207UN0901X
ARE9960207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E18034Medicare UPIN