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Individual

GARY MARK WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
4901 E JOHNSON AVE, JONESBORO, AR 72405-8417
(870) 936-8000
(870) 934-3659
Mailing address
PO BOX 1960, JONESBORO, AR 72403-1960
(870) 936-8000
(870) 934-3659

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2013026042
MO
363LF0000X
Family Nurse Practitioner
Primary
A004043
AR

Other

Enumeration date
07/24/2013
Last updated
09/12/2024
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