Individual
STACY LEANN WILBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1111 WINDOVER RD, JONESBORO, AR 72401-6159
(870) 936-8000
(870) 336-3214
Mailing address
PO BOX 1960, JONESBORO, AR 72403-1960
(870) 936-8000
(870) 336-3214
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
E-4415
AR
207Q00000X
Family Medicine Physician
Primary
E4415
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166880001
—
AR
Enumeration date
12/21/2006
Last updated
10/18/2018
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