Mr Gary Michael Petrus, MD is a
Surgery - Plastic And Reconstructive Surgery physician based in N Little Rock, Arkansas. Mr Gary Michael Petrus is licensed to practice in Arkansas (license number C7318) and his current practice location is 4137 John F Kennedy Blvd Ste A, N Little Rock, Arkansas. He can be reached at his office (for appointments etc.) via phone at
(501) 614-3052.
NPI number for Mr Gary Michael Petrus is 1568525806 and his current mailing address is Po Box 241580, Little Rock, Arkansas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1568525806.
Physician's Profile
| Full Name | Mr Gary Michael Petrus |
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| Gender | Male |
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| Speciality | Surgery - Plastic And Reconstructive Surgery |
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| Location | 4137 John F Kennedy Blvd Ste A, N Little Rock, Arkansas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1568525806
- Provider Enumeration Date: 12/18/2006
- Last Update Date: 01/25/2019
Medical Identifiers
Medical identifiers for Mr Gary Michael Petrus such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1568525806 | NPI | - | NPPES |
| 114482001 | Medicaid | AR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2082S0099X | Plastic Surgery - Plastic Surgery Within The Head And Neck | C7318 (Arkansas) | Secondary |
| 2086S0122X | Surgery - Plastic And Reconstructive Surgery | C7318 (Arkansas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Gary Michael Petrus is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Gary Michael Petrus, MD
Po Box 241580,
Little Rock, AR 72223-0011
Ph: (501) 614-3052 | Mr Gary Michael Petrus, MD
4137 John F Kennedy Blvd Ste A,
N Little Rock, AR 72116-8230
Ph: (501) 614-3052 |
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