Provider Demographics
NPI:1689651911
Name:HARPER, GARY E (MD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:E
Last Name:HARPER
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 1:123 PEARL AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5959
Mailing Address - Country:US
Mailing Address - Phone:501-375-3000
Mailing Address - Fax:501-375-1317
Practice Address - Street 1:123 PEARL AVE
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5959
Practice Address - Country:US
Practice Address - Phone:501-375-3000
Practice Address - Fax:501-375-1317
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-4827207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1116100000OtherQUALCHOICE OF AR
P00267279OtherRAILROAD MEDICARE
185446OtherUHC
AR102540001Medicaid
AR1116100000OtherQUALCHOICE OF AR
AR52134Medicare PIN