Individual
WILLIAM TAYLOR MIDDLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
1200 S ELMIRA AVE, RUSSELLVILLE, AR 72802-9646
(479) 968-7118
(479) 968-8628
Mailing address
PO DRAWER 2109, RUSSELLVILLE, AR 72811
(479) 967-2322
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR2078
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
242631721
—
AR
Enumeration date
11/30/2015
Last updated
01/10/2023
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