Provider Demographics
NPI:1225084577
Name:WHARTON, JOE H (MD)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:H
Last Name:WHARTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 850
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:AR
Mailing Address - Zip Code:71671-0850
Mailing Address - Country:US
Mailing Address - Phone:870-226-6786
Mailing Address - Fax:870-226-5638
Practice Address - Street 1:1012 E CHURCH ST
Practice Address - Street 2:SUITE C
Practice Address - City:WARREN
Practice Address - State:AR
Practice Address - Zip Code:71671-3509
Practice Address - Country:US
Practice Address - Phone:870-226-6786
Practice Address - Fax:870-226-5638
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC6689207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR080133613OtherRAILROAD MEDICARE
AR710815809OtherAETNA
ARB90668OtherUPIN
AR111612001Medicaid
AR1279200000OtherQUALCHOICE
AR710815809OtherUNITED HEALTHCARE
AR080133613OtherRR MEDICARE
AR710815809OtherHEALTHLINK
AR111612001Medicaid
AR710815809OtherHEALTHLINK