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CHARLES WESLEY HIMMLER DO
>> Family Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1750349858
Individual Registrant: CHARLES WESLEY HIMMLER DO
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
1159 MAIN STREET VILONIA, AR 72173 US
Tel: 501-796-8484 Fax: 501-796-2453
Tel: 501-796-8484 Fax: 501-796-2453
Contact information for business:
PO BOX 359 VILONIA, AR 72173 US
Tel: 501-796-8484 Fax: 501-796-2453
Tel: 501-796-8484 Fax: 501-796-2453
Registration Information:
NPI: 1750349858
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207Q00000X | Allopathic & Osteopathic Physicians Family Medicine | AR | N7807 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 116681003 | AR | 05 |
