Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD434335 | PA |
Y | 207XS0106X | Orthopaedic Hand Surgeon | E-6235 | AR |
NPI | 1154540490 |
---|---|
Provider Name | Theresa Wyrick |
First Address | Little Rock, AR 72202-3500 |
Second Address | Little Rock, AR 72202-3500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2007 |
Last Update Date | 06/03/2020 |