Individual
BROCK HARRISON WRINKLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1801 CENTRAL AVE STE A, HOT SPRINGS, AR 71901-6800
(501) 623-5598
(501) 623-5516
Mailing address
6 TRENT JONES CV, SHERWOOD, AR 72120-4611
(501) 599-8400
(501) 623-5598
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
PA-720
AR
363AM0700X
Medical Physician Assistant
PT2017-010
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1139067
NCCPA
—
01
—
PA-720
ARKANSAS STATE MEDICAL BOARD
AR
Enumeration date
02/11/2017
Last updated
03/21/2023
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