Individual
FARRYL WILBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4000 DUNWOODY PARK APT 5405, DUNWOODY, GA 30338-7968
(504) 858-5887
Mailing address
4301 W MARKHAM ST, LITTLE ROCK, AR 72205-7101
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10829
GA
Other
Enumeration date
10/07/2016
Last updated
12/23/2024
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