Individual
JAMES WILSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1679 HIGHWAY 243 SOUTH, MARIANNA, AR 72360
(870) 295-3557
(870) 295-3686
Mailing address
1679 HIGHWAY 243 SOUTH, MARIANNA, AR 72360
(870) 295-3557
(870) 295-3686
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
101
AR
3747P1801X
Personal Care Attendant
Primary
32903
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121812732
—
AR
Enumeration date
12/26/2006
Last updated
12/27/2024
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