Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | C5112 | AR |
NPI | 1639380686 |
---|---|
Provider Name | Paul Frank Wilbur |
First Address | Mountain Home, AR 72653-6114 |
Second Address | Mountain Home, AR 72653-6114 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 08/07/2007 |