Wingo, Susan
Wingo, Susan is an individual health care provider with primary practice located at 1306 W Collin Raye Dr , De Queen AR 71832-2502. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Wingo, Susan can be contacted via phone (870) 642-7572.Contact Information
Primary practice address
1306 W Collin Raye Dr
De Queen AR 71832-2502
Phone: (870) 642-7572
Fax: (870) 584-4100
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | E3749 | Arkansas |
Profile Details
| NPI number | 1730170168 |
|---|---|
| LBN Legal business name | Wingo, Susan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 3rd, 2005 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730170168 | NPPES |
| Arkansas | Other | 5M695 | AR BCBS |
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