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General NPI Number Information
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NPI Number | 1801054440
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Entity Type | Individual
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Provider Name | AIMEE ELIZABETH WIDNER M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 746 WILBURN RD
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City | HEBER SPRINGS
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State | AR
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Zip | 72543-8902
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Country | US
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Telephone | 501-270-4116
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Fax |
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Provider Business Mailing Address
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Address Line | 746 WILBURN ROAD
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City | HEBER SPRINGS
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State | AR
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Zip | 72543-8902
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Country | US
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Telephone | 501-270-4116
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 070011
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | E-9529
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License Number State | AR
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