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General NPI Number Information
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NPI Number | 1003925975
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Entity Type | Individual
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Provider Name | LEE G. WILBUR MD
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 6221 COLONEL GLENN RD STE B
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City | LITTLE ROCK
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State | AR
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Zip | 72204-7731
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Country | US
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Telephone | 501-441-5558
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Fax |
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Provider Business Mailing Address
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Address Line | 6221 COLONEL GLENN RD STE B
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City | LITTLE ROCK
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State | AR
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Zip | 72204-7731
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Country | US
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Telephone | 501-441-5558
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 01058967A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | E8306
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License Number State | AR
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