Individual
DR. RICHARD ROYCE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
245 MADISON ST, CLARENDON, AR 72029-2706
(870) 747-3381
(870) 747-3631
Mailing address
245 MADISON ST, CLARENDON, AR 72029-2706
(870) 747-3381
(870) 747-3631
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C5461
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102743001
—
AR
Enumeration date
06/16/2006
Last updated
08/21/2012
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