DR. JON M GUSTAFSON MD NPI 1275583551

NPI Information

NPI: 1275583551
Provider Name: DR. JON M GUSTAFSON, MD
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

PECOS Registration: Yes

Address:
320 N GREENWOOD AVE
FORT SMITH, AR
ZIP 72901
Phone: (479) 434-2743
Get Directions

DR. Jon M Gustafson, MD is a neurology psychiatry neurology in Fort Smith, AR with 37 years of experience. The provider is 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. DR. Jon M Gustafson, MD NPI is 1275583551. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: ORAL ROBERTS UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1987

The provider's business location address is:

320 N GREENWOOD AVE
FORT SMITH, AR
ZIP 72901-454
Phone: (479) 434-2743
Fax: (844) 454-8351

The NPI 1275583551 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/10/2006 and was last updated on 4/23/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084N0400X	Psychiatry & Neurology	Neurology	29264	KENTUCKY	No
2	2084N0400X	Psychiatry & Neurology	Neurology	E-5459	ARKANSAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	200126290A	MEDICAID	OKLAHOMA
2	167300001	MEDICAID	ARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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