Provider Demographics
NPI:1316296668
Name:GAYAM, VIJAY BHASKAR REDDY (MD)
Entity type:Individual
Prefix:DR
First Name:VIJAY BHASKAR
Middle Name:REDDY
Last Name:GAYAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 776084
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6084
Mailing Address - Country:US
Mailing Address - Phone:479-338-3030
Mailing Address - Fax:479-338-3079
Practice Address - Street 1:2708 S RIFE MEDICAL LN STE 300
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1457
Practice Address - Country:US
Practice Address - Phone:479-338-3030
Practice Address - Fax:479-338-3079
Is Sole Proprietor?:No
Enumeration Date:2012-08-31
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXU9254207RG0100X
ARE-19843207RG0100X
NY281594207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine