Individual
RICK WAYNE HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 SKYLINE DR, RUSSELLVILLE, AR 72801-3363
(479) 968-2345
(479) 890-7169
Mailing address
101 SKYLINE DR, RUSSELLVILLE, AR 72801-3363
(479) 968-2345
(479) 890-7169
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
C-6833
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114304001
—
AR
Enumeration date
04/25/2006
Last updated
02/18/2015
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