| Kh Development Pa | |
|
2 Saint Vincent Cir Little Rock AR 72205-5423 | |
| (501) 552-3000 | |
| (479) 505-0319 |
| Full Name | Kh Development Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2 Saint Vincent Cir, Little Rock, Arkansas |
| Authorized Official Name and Position | Hunter Gibbs (MD/ OWNER) |
| Authorized Official Contact | 5015523000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kh Development Pa 4322 I St Little Rock AR 72205-2054 Ph: (501) 526-3000 | Kh Development Pa 2 Saint Vincent Cir Little Rock AR 72205-5423 Ph: (501) 552-3000 |
| NPI Number | 1114626579 |
|---|---|
| Provider Enumeration Date | 02/24/2023 |
| Last Update Date | 03/22/2024 |
| Certification Date | 03/22/2024 |
| Medicare PECOS PAC ID | 1355714437 |
|---|---|
| Medicare Enrollment ID | O20230310002694 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114626579 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Hunter M Gibbs |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437416021 PECOS PAC ID: 1153647862 Enrollment ID: I20170926001758 |
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