Individual
CHARLES WESLEY HIMMLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1159 MAIN STREET, VILONIA, AR 72173
(501) 796-8484
(501) 796-2453
Mailing address
PO BOX 359, VILONIA, AR 72173
(501) 796-8484
(501) 796-2453
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
N7807
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116681003
—
AR
Enumeration date
05/01/2006
Last updated
05/23/2008
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