Individual
MRS. NATASHA MARIE WANTULOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2901 MEDICAL CENTER DR, POCAHONTAS, AR 72455-9438
(870) 892-4467
(870) 892-4407
Mailing address
2901 MEDICAL CENTER DR, POCAHONTAS, AR 72455-9438
(870) 892-4467
(870) 892-4407
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-10809
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
229157001
—
AR
Enumeration date
04/08/2015
Last updated
10/22/2018
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