Individual
REBECCA RUSSELL WHEELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 W 40TH AVE, PINE BLUFF, AR 71603-6301
(870) 541-7524
(870) 541-7543
Mailing address
1600 W 40TH AVE, PINE BLUFF, AR 71603-6301
(870) 541-7524
(870) 541-7543
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
C8173
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126119001
—
AR
Enumeration date
06/11/2006
Last updated
07/07/2010
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