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:
Health care specialties
| Specialty | Code | License # | 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 last year |
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 | 1144217373 | NPPES |
| Arkansas | MEDICAID | 149763001 | |
| Arkansas | Other | 8K6572 |
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