Doctor Name: | WALKER DYER |
NPI Number: | 1043629900 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | APRN |
License Number: | A004161 |
Business Practice Address: | 2000 S 42nd St Ste 100 Rogers, AR - 727582001 |
Business Phone Number: | 4792739173 |
Business Fax Number: | 4794649989 |
Mailing Address: | 2158 Butterfield Coach Rd, Ste 100 SPRINGDALE |
State: | AR |
Postal Code: | 727649142 |
Phone Number: | 4797575023 |
Fax Number: | |
NPI Enumeration Date: | 08/05/2014 |
NPI Last Update Date: | 05/10/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | A004161 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |