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Individual

RICHARD A. WYATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9500 KANIS RD, SUITE 200, LITTLE ROCK, AR 72205-6324
(501) 224-6699
(501) 224-7752
Mailing address
9500 KANIS RD, SUITE 200, LITTLE ROCK, AR 72205-6324
(501) 224-6699
(501) 224-7752

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
N-6335
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102659001
AR
01
114860000-00
QUALCHOICE
AR
01
160015704
RAILROAD MEDICARE
AR
01
4206569
AETNA
AR
01
55878
BCBS
AR
01
710619986
CIGNA
AR
01
862499
UNITED HEALTHCARE
AR
Enumeration date
06/09/2006
Last updated
05/19/2008
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