Organization
NORTHWEST ARKANSAS UROLOGY ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL R WILSON M.D. (SECRETARY)
(479) 521-8980
Entity
Organization
Contact information
Practice address
1300 E ZION RD, FAYETTEVILLE, AR 72703-5015
(479) 521-8980
(479) 521-8982
Mailing address
1300 E ZION RD, FAYETTEVILLE, AR 72703-5015
(479) 521-8980
(479) 521-8982
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106298002
—
AR
Enumeration date
04/26/2006
Last updated
09/26/2008
Update your record
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