Wooten, Edward Wrenn

Wooten, Edward Wrenn is an individual health care provider with primary practice located at 3344 N Futrall Dr , Fayetteville AR 72703-4057. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Wooten, Edward Wrenn can be contacted via phone (479) 443-5316.

Contact Information

Primary practice address
3344 N Futrall Dr Fayetteville AR 72703-4057
Phone: (479) 443-5316
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X E3681 Arkansas
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X L4179 Texas

Profile Details

NPI number 1144217373
LBN Legal business name Wooten, Edward Wrenn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2005
Last updated Sep 29th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144217373 NPPES
Arkansas MEDICAID 149763001
Arkansas Other 8K6572

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