Provider Demographics
NPI:1679861702
Name:GAMARRA-HILBURN, CARLA FABIOLA (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:FABIOLA
Last Name:GAMARRA-HILBURN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:9101 KANIS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6455
Mailing Address - Country:US
Mailing Address - Phone:501-224-6366
Mailing Address - Fax:501-725-8445
Practice Address - Street 1:9101 KANIS RD STE 200
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6455
Practice Address - Country:US
Practice Address - Phone:501-224-6366
Practice Address - Fax:501-725-8445
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA249445207R00000X
IN01076656A207RR0500X
ARE-13113207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5EY59OtherBCBS OF AR
AR1G0537OtherMEDICARE
IN201361070Medicaid
AR247019001Medicaid
ININ1189053OtherIN MEDICARE