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Individual

DR. LAURA WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1308 E KIEHL AVE, SHERWOOD, AR 72120-3040
(501) 835-0703
(501) 834-6249
Mailing address
1308 E KIEHL AVE, SHERWOOD, AR 72120-3040
(501) 835-0703
(501) 834-6249

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
E-4416
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05070026700
QUALCHIOICE
AR
05
157741001
AR
01
5N239
BLUE CROSS
AR
01
7226719
AETNA
AR
Enumeration date
06/15/2006
Last updated
09/23/2008
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