Individual
DR. JOHN PALMER WEDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
301 S J T STITES ST, SALLISAW, OK 74955-9302
(918) 775-9159
(479) 709-8687
Mailing address
3500 WE KNIGHT DR, FORT SMITH, AR 72903-6248
(479) 709-8686
(479) 709-8687
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
E-1681
AR
207Q00000X
Family Medicine Physician
Primary
3297
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100077380A
—
OK
05
—
134699003
—
AR
01
—
5K787
BLUECROSS BLUESHIELD
AR
01
—
930089348
RR MEDICARE
AR
Enumeration date
01/13/2006
Last updated
08/19/2022
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