Individual
LEE G. WILBUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6221 COLONEL GLENN RD STE B, LITTLE ROCK, AR 72204-7731
(501) 441-5558
(501) 441-4041
Mailing address
6221 COLONEL GLENN RD STE B, LITTLE ROCK, AR 72204-7731
(501) 441-5558
(501) 441-4041
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01058967A
IN
207P00000X
Emergency Medicine Physician
Primary
E8306
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000331511
ANTHEM
IN
05
—
200238230
—
IN
05
—
201811001
—
AR
01
—
P00924303
RAILROAD MEDICARE PTAN
IN
Enumeration date
08/30/2006
Last updated
03/06/2026
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