Individual
DAI-YUAN WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2205 W MAIN ST, RUSSELLVILLE, AR 72801-2759
(479) 968-4311
(479) 968-4399
Mailing address
2205 W MAIN ST, RUSSELLVILLE, AR 72801-2759
(479) 968-4311
(479) 968-4399
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036112423
IL
207RC0000X
Cardiovascular Disease Physician
207229
NY
207RC0000X
Cardiovascular Disease Physician
Primary
E-5291
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036112423
—
IL
05
—
166953001
—
AR
01
—
P00204251
RAILROAD MEDICARE
IL
Enumeration date
08/02/2006
Last updated
03/27/2023
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