Individual
MARK WENDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3800 E JOHNSON AVE, STE E, JONESBORO, AR 72401-1931
(870) 932-0399
(870) 932-0499
Mailing address
3800 E JOHNSON AVE, STE E, JONESBORO, AR 72401-1931
(870) 932-0399
(870) 932-0499
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
E-5359
AR
2085R0204X
Vascular & Interventional Radiology Physician
Primary
E-5359
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176716001
—
AR
Enumeration date
04/09/2007
Last updated
10/20/2016
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