Organization
NORTHWEST ARKANSAS UROLOGY ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL R WILSON MD (PRESIDENT)
(479) 521-8980
Entity
Organization
Contact information
Practice address
1300 E ZION RD, FAYETTEVILLE, AR 72703-5015
(479) 521-8980
(479) 521-1088
Mailing address
1300 E ZION RD, FAYETTEVILLE, AR 72703-5015
(479) 521-8980
(479) 521-1088
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MC-2938
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MC-2938
MEDCIAL LICENSE
AR
Enumeration date
11/19/2013
Last updated
11/19/2013
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