MEDICARE: WESLEY BRENT SPRINKLE D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	E-2728	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	5M527C207	OTHER	AR	PTAN

General Provider Information

NPI Number	:	1265410443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WESLEY BRENT SPRINKLE D.O.

Provider Business Mailing Address
First Line	:	600 S MCKINLEY ST
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-5202
Country	:	US
Telephone Number	:	501-663-3647
Fax Number	:	501-663-7931

Provider Business Practice Location Address
First Line	:	600 S MCKINLEY ST
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-5202
Country	:	US
Telephone Number	:	501-663-3647
Fax Number	:	501-663-7931

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	11/11/2010

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1487617429 — MARTHA KAY BUSHMIAER APN
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Directions to “ WESLEY BRENT SPRINKLE D.O.” Practice Location

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