Michael R Wilson, MD | |
1300 E Zion Rd, Fayetteville, AR 72703-5015 | |
(479) 521-8980 | |
(479) 521-8982 |
Full Name | Michael R Wilson |
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Gender | Male |
Speciality | Urology |
Location | 1300 E Zion Rd, Fayetteville, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1417914813 | NPI | - | NPPES |
146880001 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | E-3255 (Arkansas) | Primary |
Entity Name | Northwest Arkansas Urology Associates, Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720418213 PECOS PAC ID: 9739311499 Enrollment ID: O20140410002014 |
Mailing Address | Practice Location Address |
---|---|
Michael R Wilson, MD 1300 E Zion Rd, Fayetteville, AR 72703-5015 Ph: (479) 521-8980 | Michael R Wilson, MD 1300 E Zion Rd, Fayetteville, AR 72703-5015 Ph: (479) 521-8980 |
Richard D Mcwhorter, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 2 East Appleby Rd., Suite 201, Fayetteville, AR 72703 Phone: 479-404-1100 Fax: 479-404-1101 | |
William Vernon Fairchild, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 1100 N College Ave, Fayetteville, AR 72703 Phone: 479-443-4301 | |
Dr. Aleksandar Cody Blubaum, MD Urology Medicare: Medicare Enrolled Practice Location: 3 E Appleby Rd Ste 201, Fayetteville, AR 72703 Phone: 479-404-1100 | |
Charles Mark Jackson, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 3 E Appleby Rd Ste 201, Fayetteville, AR 72703 Phone: 479-404-1100 Fax: 479-404-1101 | |
Dr. Issam Toufic Shalhoub, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 1100 N College Ave, Fayetteville, AR 72703 Phone: 479-443-4301 | |
Truman Stephen Shaddox, M.D. Urology Medicare: Medicare Enrolled Practice Location: 12 E Appleby Rd, Ste 101, Fayetteville, AR 72703 Phone: 479-463-4444 Fax: 479-463-4499 |