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MR. FRED EUGENE WILSON MD

Rural Health >> Clinic/Center >> Ambulatory Health Care Facilities

Registrant NPI Number: 1265530984

Individual Registrant:
MR. FRED EUGENE WILSON MD
Gender: M
Sole Proprietor

Location and contact information for practice:
908 NORTH EDMONDS  MC CRORY, AR 72101-0780 US
Tel: 870-731-1100  Fax: 870-731-1019

Contact information for business:
PO BOX 780 908 NORTH EDMONDS MC CRORY, AR 72101-0780 US
Tel: 870-731-1100  Fax: 870-731-1019

Registration Information:
NPI: 1265530984
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y261QR1300XAmbulatory Health Care Facilities
Clinic/Center
Rural Health

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
134474729AR05
134056002AR05




HEALTH CARE JOBS AR - Page 1



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