Individual
WOLF E HEBERLEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3800 E JOHNSON AVE, STE E, JONESBORO, AR 72401-1931
(870) 932-0399
(870) 932-0499
Mailing address
3800 E JOHNSON AVE, STE E, JONESBORO, AR 72401-1931
(870) 932-0399
(870) 932-0499
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
E-5565
AR
208VP0014X
Interventional Pain Medicine Physician
Primary
E-5565
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168510001
—
AR
01
—
P00622537
RAILROAD MEDICARE
AR
Enumeration date
04/09/2007
Last updated
10/20/2016
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