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James Wilson JR.
Lodging Provider in Marianna, Arkansas
NPI 1063577682

James Wilson JR. is a Lodging Provider based in Marianna, AR. James Wilson JR. practices in Marianna, AR. The NPI Number for James Wilson JR. is 1063577682 and holds a License No. 101 (Arkansas).

The current practice location address for James Wilson JR. is 1679 Highway 243 South, Marianna, AR and can be reached out via phone at 870-295-3557 and via fax at 870-295-3686.

Location: 1679 Highway 243 South, Marianna, AR, 72360
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1063577682
Provider Name
James Wilson JR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
1679 Highway 243 South, Marianna, AR, 72360
Phone Number
870-295-3557
Fax Number
870-295-3686
Provider Enumeration Date
12/26/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
121812732 05 AR
institution
Provider Business Practice Location Address Details
Address
1679 Highway 243 South
City
Marianna
State
Arkansas
Zip
72360
Phone Number
870-295-3557
Fax Number
870-295-3686
person
Provider Business Mailing Address Details
Address
1679 Highway 243 South
City
Marianna
State
Arkansas
Zip
72360
Phone Number
870-295-3557
Fax Number
870-295-3686
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Lodging
Speciality
-
Taxonomy
177F00000X
License No.
101 (Arkansas)
Definition
A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
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