DR. JON M GUSTAFSON (NPI# 1275583551) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275583551 |
| Entity Type | Individual |
| Full Name | DR. JON M GUSTAFSON |
| Credential | MD |
| Practice Address |
5701 Euper Ln Ste B Fort Smith AR 72903-3255 |
| Mailing Address |
7009 Naples Way Fort Smith AR 72916-8701 |
| Practice Telephone | 4794342743 |
| Practice Fax Number | 8444548351 |
| Mailing Telephone | 4794317234 |
| Mailing Fax Number | 8444548351 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-06-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
E-5459 | AR | Allopathic & Osteopathic Physicians |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
29264 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200126290A | 05 | |
| AR | 167300001 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5701 Euper Ln Ste B, Fort Smith, AR 729033255 | 4794342743 | 8444548351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407272974 | Jon Montgomery Gustafson | Veterinarian | 4636 55th St, Boulder, CO 80301-3005 | 2014-03-08 |
| Street Address |
5701 EUPER LN STE B |
| City | FORT SMITH |
| State | AR |
| Zip Code | 72903-3255 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538267414 | Clinical Neuroscience Associates, Inc. | Specialist | 5701 Euper Ln Ste B, Fort Smith, AR 72903-3255 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285280016 | Bhg L, LLC | Clinic/Center | 1501 Waldron Road, Ste 203, Fort Smith, AR 72903 | 2019-08-16 |
| 1457905903 | Heather Snyder | Optometrist | 1021 South Waldron Road, Fort Smith, AR 72903 | 2019-08-01 |
| 1083272223 | Pediatric Therapy Connections LLC | Clinic/Center | 7601 Westminister Pl, Fort Smith, AR 72903 | 2019-06-03 |
| 1073092821 | Baptist Health Services | Psychiatry & Neurology | 3808 Gary St Ste B, Fort Smith, AR 72903 | 2018-08-13 |
| 1104305853 | Baptist Health Services | Family Medicine | 5428 Ellsworth Rd Ste A, Fort Smith, AR 72903 | 2018-08-13 |
| 1417436171 | Baptist Health Services | Pediatrics | 5428 Ellsworth Rd Ste B, Fort Smith, AR 72903 | 2018-08-13 |
| 1558840421 | Baptist Health Services | Family Medicine | 3808 Gary St Ste A, Fort Smith, AR 72903 | 2018-08-10 |
| 1316434707 | Md Weight Loss and Wellness, LLC | Dietitian, Registered | 3416 Old Greenwood Road, Fort Smith, AR 72903 | 2018-04-20 |
| 1942695572 | Donna K Morgan | Counselor | 2408 S. 51st Court Suite G, Fort Smith, AR 72903 | 2015-03-31 |
| 1346658242 | Shelby Mural Esry | Dentist | 3200 Rogers Ave. Suite 111, Fort Smith, AR 72903 | 2014-07-24 |
| Find all providers in zip 72903 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073092821 | Baptist Health Services | Psychiatry & Neurology | 3808 Gary St Ste B, Fort Smith, AR 72903 | 2018-08-13 |
| 1588143259 | Baptist Health Services | Psychiatry & Neurology | 1500 Dodson Ave Ste 290, Fort Smith, AR 72901 | 2018-08-13 |
| 1982082970 | Ernest Escarza Serrano | Psychiatry & Neurology | 3405 Ramsgate Way, Fort Smith, AR 72908-9359 | 2015-05-11 |
| 1265688956 | Southwest Neurologicl Institute Pa | Psychiatry & Neurology | 3011 Jenny Lind Rd, Fort Smith, AR 72901 | 2008-08-13 |
| 1952323297 | Tonya L Phillips | Psychiatry & Neurology | 3808 Gary St, Suite B, Fort Smith, AR 72903-5450 | 2006-07-24 |
| 1710974647 | Duane L Birky | Psychiatry & Neurology | 408 S 16th St, Fort Smith, AR 72901-4626 | 2005-10-05 |
| 1578021903 | Belclin LLC | Psychiatry & Neurology | 3011 Jenny Lind Rd, Fort Smith, AR 72901-6736 | 2019-03-05 |
| 1790170223 | Sujan Teegala Sudarshan Reddy | Psychiatry & Neurology | 7301 Rogers Ave, Fort Smith, AR 72903-4100 | 2015-04-01 |
| 1174895940 | Fort Smith Hma Pbc Management, LLC | Psychiatry & Neurology | 1500 Dodson Ave, Suite 175, Fort Smith, AR 72901-5182 | 2012-02-08 |
| 1023301819 | Satish Kumar Reddy Gaddam | Psychiatry & Neurology | 1504 Dodson Ave, Fort Smith, AR 72901-5128 | 2011-05-26 |
| Find all providers in FORT SMITH | ||||
| City | FORT SMITH |
| Zip Code | 72903 |
Please comment or provide details below to improve the information on DR. JON M GUSTAFSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.