Individual
MARLA L WIRGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
16221 SAINT VINCENT WAY STE 300, LITTLE ROCK, AR 72223-9072
(501) 817-3923
(501) 817-3930
Mailing address
16221 SAINT VINCENT WAY STE 300, LITTLE ROCK, AR 72223-9072
(501) 817-3923
(501) 817-3930
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
E-5842
AR
207N00000X
Dermatology Physician
M2205
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13588737
—
NM
01
—
150336100
FIRSTCARE COMMERCIAL
TX
05
—
150336101
—
TX
05
—
174846001
—
AR
05
—
181172101
—
TX
05
—
181172102
—
TX
05
—
200086270A
—
OK
01
—
202008119
PRESBYTERIAN COMMERCIAL
NM
05
—
202008119
—
NM
01
—
8J1461
BLUE CROSS BLUE SHIELD
TX
01
—
8M1174
HMO BLUE
TX
Enumeration date
07/08/2006
Last updated
07/11/2019
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