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General NPI Number Information
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NPI Number | 1609128883
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Entity Type | Organization
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Legal Business Name | DR. WIL R. MCCAULEY, P.A.
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Dates
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Enumeration Date | 10/11/2012
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Last Update Date | 10/11/2012
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Provider Practice Location Address
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Address Line | 609 SW 8TH ST SUITE 600
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City | BENTONVILLE
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State | AR
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Zip | 72712-7886
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Country | US
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Telephone | 479-286-1133
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Fax |
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Provider Business Mailing Address
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Address Line | 609 SW 8TH ST SUITE 600
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City | BENTONVILLE
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State | AR
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Zip | 72712-7886
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIEF PHYSICIAN
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Name | DR. WILLIAM RUSSELL MCCAULEY
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Credential | D.C.
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Telephone | 479-286-1133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 15716
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License Number State | AR
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