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NPI Code Detail

MEDICARE: MR. HAROLD WILKES BRANCH JR. M.D.

MEDICARE:  MR. HAROLD WILKES BRANCH JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianE3831AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
103120012000OTHERARQUALCHOICE
2652514OTHERARHEALTHLINK
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4100212OTHERARUNITED HEALTHCARE
57839508OTHERARAETNA

General Provider Information

NPI Number : 1164466603
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. HAROLD WILKES BRANCH JR. M.D.
Provider Business Mailing Address
First Line : PO BOX 783
Second Line :
City : BEEBE
State : AR
Zip : 72012-0783
Country : US
Telephone Number : 501-882-3388
Fax Number : 501-882-3300
Provider Business Practice Location Address
First Line : 47 HIGHWAY 64 W
Second Line :
City : BEEBE
State : AR
Zip : 72012-9500
Country : US
Telephone Number : 501-882-3388
Fax Number : 501-882-3300
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 05/21/2008

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Directions to “ MR. HAROLD WILKES BRANCH JR. M.D.” Practice Location

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