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General NPI Number Information
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NPI Number | 1942226584
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Entity Type | Organization
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Legal Business Name | HEALTH PLUS
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1012 E 22ND ST
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City | STUTTGART
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State | AR
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Zip | 72160-6825
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Country | US
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Telephone | 870-673-2628
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Fax | 870-673-2620
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Provider Business Mailing Address
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Address Line | 1012 E 22ND ST
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City | STUTTGART
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State | AR
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Zip | 72160-6825
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Country | US
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Telephone | 870-673-2628
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Fax | 870-673-2620
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. RICHARD R WILSON
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Credential | M.D.
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Telephone | 870-673-2628
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C5461
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License Number State | AR
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