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Individual

JOHN A. WISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
9601 BAPTIST HEALTH DR STE 200, LITTLE ROCK, AR 72205-6342
(501) 223-2870
(501) 223-2258
Mailing address
11001 EXECUTIVE CENTER DR STE 200, LITTLE ROCK, AR 72211-4393
(501) 812-7215
(501) 812-7807

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
1395
TN
363AS0400X
Surgical Physician Assistant
Primary
1072420
AR
363AS0400X
Surgical Physician Assistant
Primary
1395
TN
363AS0400X
Surgical Physician Assistant
Primary
PA-1232
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
TN
Enumeration date
10/11/2006
Last updated
02/26/2026
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