Individual
WILSON JAVIER CRUZ-LEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1480 W CENTER ST, GREENWOOD, AR 72936-3449
(479) 996-5585
(479) 996-5386
Mailing address
PO BOX 11449, BELFAST, ME 04915-4005
(479) 709-1924
(479) 709-7499
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A106916
CA
207Q00000X
Family Medicine Physician
Primary
E5921
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC71030F
—
CA
Enumeration date
09/27/2006
Last updated
11/23/2016
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