Individual
JASON H WARDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
10301 KANIS RD, LITTLE ROCK, AR 72205-6205
(501) 604-6900
(501) 604-6941
Mailing address
10301 KANIS RD, LITTLE ROCK, AR 72205-6205
(501) 604-6900
(501) 604-6941
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA235
AR
363AM0700X
Medical Physician Assistant
PA235
AR
363AS0400X
Surgical Physician Assistant
PA235
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204192795
—
AR
Enumeration date
04/17/2006
Last updated
02/03/2015
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