Individual
MR. ROBERT CLYDE WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
2801 MEDICAL CENTER DR, POCAHONTAS, AR 72455-9436
(870) 972-8053
(870) 972-8053
Mailing address
1210 W COUNTRY CLUB TER, JONESBORO, AR 72401-4374
(870) 972-1605
(870) 972-8053
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C00474 CRNA
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115446701
—
AR
05
—
915192819
—
MO
Enumeration date
01/25/2007
Last updated
01/17/2023
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