Individual
DR. STANLEY WAYNE BURLESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
705 W 16TH ST, DEWITT, AR 72042
(870) 946-1326
(870) 946-4335
Mailing address
PO BOX 352, DEWITT, AR 72042
(870) 946-1326
(870) 946-4335
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C-5377
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102980001
—
AR
01
—
14220000000
PUAL CHOICE
—
01
—
M038602
UNITED HEALTHCARE
—
Enumeration date
09/11/2006
Last updated
03/01/2024
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