Provider Demographics
NPI:1699781427
Name:GERA, SUNIL (MD)
Entity type:Individual
Prefix:DR
First Name:SUNIL
Middle Name:
Last Name:GERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 SOUTHWEST SQUARE
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401
Mailing Address - Country:US
Mailing Address - Phone:870-910-6666
Mailing Address - Fax:870-931-1114
Practice Address - Street 1:2601 SOUTHWEST SQUARE
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401
Practice Address - Country:US
Practice Address - Phone:870-910-6666
Practice Address - Fax:870-931-1114
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE1626208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR140696001Medicaid
H14806Medicare UPIN
AR140696001Medicaid
AR5L469Medicare PIN