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General NPI Number Information
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NPI Number | 1720135015
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Entity Type | Individual
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Provider Name | MICHAEL AARON WHEELER O.D.
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Gender | Male
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | 360 HIGHWAY 5 N
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-3039
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Country | US
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Telephone | 870-425-2277
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Fax | 870-425-2021
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Provider Business Mailing Address
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Address Line | 102 SPRING ST
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City | MELBOURNE
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State | AR
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Zip | 72556-9241
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Country | US
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Telephone | 870-368-7921
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Fax | 870-368-7789
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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 | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | 2558
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | 2005020771
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License Number State | MO
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