Organization
WYNNE MEDICAL CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHELIA BURROW (OFFICE MANAGER)
(870) 238-2321
Entity
Organization
Contact information
Practice address
710 FALLS BLVD S, WYNNE, AR 72396-3514
(870) 238-2321
(870) 238-0114
Mailing address
PO BOX 158, WYNNE, AR 72396-0158
(870) 238-2321
(870) 238-0114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102040002
—
AR
Enumeration date
08/23/2006
Last updated
09/24/2013
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