Individual
LOUISA DUKE WICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
705 SANTA FE DR, SEARCY, AR 72143-6964
(501) 268-3853
(501) 268-3856
Mailing address
705 SANTA FE DR, SEARCY, AR 72143-6964
(501) 268-3853
(501) 268-3856
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-377
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200825795
—
AR
Enumeration date
06/10/2006
Last updated
04/16/2018
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