Provider Demographics
NPI:1588676571
Name:CECIL W GABY MD PA
Entity Type:Organization
Organization Name:CECIL W GABY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELLNIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GABY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-452-7447
Mailing Address - Street 1:7303 ROGERS AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-4165
Mailing Address - Country:US
Mailing Address - Phone:479-452-7447
Mailing Address - Fax:479-452-6693
Practice Address - Street 1:7303 ROGERS AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-4165
Practice Address - Country:US
Practice Address - Phone:479-452-7447
Practice Address - Fax:479-452-6693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMC-2382173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty