Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | 5276300-1205 | UT |
Y | 208800000X | Urologist | E-4543 | AR |
NPI | 1003873050 |
---|---|
Provider Name | Richard D Mcwhorter |
First Address | Lowell, AR 72745 |
Second Address | Fayetteville, AR 72703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 29/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
158172001 | (05) | AR |
200103160A | (05) | OK |
5N289 | AR BCBS (01) | AR |
H86895 | (02) | |
P00363254 | RR MCR (01) | AR |