Individual
CARLY WADDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
900 S 52ND ST STE 200, ROGERS, AR 72758-8640
(352) 265-0111
Mailing address
900 S 52ND ST STE 200, ROGERS, AR 72758-8640
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
E-18081
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/23/2021
Last updated
11/25/2024
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