Unknown Individual – Gastroenterology Physician, NPI 1881603264

Unknown Individual is a healthcare provider. based in Fort smith, Arkansas. specializing in Gastroenterology Physician. They hold a License No. C-5607 (AR). The NPI Number for Unknown Individual is 1881603264

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1881603264
Phone
(479) 274-2004
Address
PO BOX 3528
Deactivation Date
8 November 2024

Doctor Profile

Medical School Name
UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
Secondary Phone
9185677000
Graduation Year
1979 (47 years ago)
PAC ID
6709863921
Group Practice PAC ID
1759294838
Professional Enrollment ID
I20151105000292
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • PO BOX 3528

    FORT SMITH, AR 729133528

    Phone: (479) 274-2004

    Fax: (479) 274-2194

    Type: Mailing

  • 6801, Rogers Avenue, Massard, Fort Smith, Sebastian County, Arkansas, 72903, United States

    FORT SMITH, AR 729034067

    Phone: (479) 274-2000

    Fax: (479) 274-2194

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 72913)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1759294838View full group profile
NameSpecialtyState
-TX
-OK
Diagnostic RadiologyOK
Nurse PractitionerOK
N E U R O L O G YAR
E N D O C R I N O L O G YAR
Mental Health CounselorOK
O P T O M E T R YOK
-OK
Interventional Radiology, Diagnostic Radiology, Diagnostic RadiologyOK

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1881603264 when you need to reference Unknown Individual in forms, claims, or directories.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Gastroenterology Physician. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Fort Smith, Arkansas for Unknown Individual based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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