Individual
MR. JOHN ROBERT WYATT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
900 W KINGSHIGHWAY, PARAGOULD, AR 72450
(870) 239-7000
Mailing address
3 LUKAS CV, PARAGOULD, AR 72450-7567
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R077091
AR
367500000X
Certified Registered Nurse Anesthetist
16514
TN
367500000X
Certified Registered Nurse Anesthetist
2024036785
MO
367500000X
Certified Registered Nurse Anesthetist
810543
MS
367500000X
Certified Registered Nurse Anesthetist
Primary
C002963
AR
Other
Enumeration date
01/03/2012
Last updated
10/02/2024
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