Individual
DR. WANDA V MCMICHEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4900 KELLEY HWY, FORT SMITH, AR 72904-5000
(479) 785-5700
(479) 785-5708
Mailing address
PO BOX 130, RATCLIFF, AR 72951-0130
(479) 635-0091
(479) 635-2010
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-0997
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080084040
RR MEDICARE
—
05
—
129704001
—
AR
Enumeration date
07/17/2006
Last updated
04/19/2017
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