Provider Demographics
NPI:1306825443
Name:WEBB, DAN WHITNEY (MD)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:WHITNEY
Last Name:WEBB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:228 W TYLER AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-4223
Mailing Address - Country:US
Mailing Address - Phone:870-735-1973
Mailing Address - Fax:870-735-5433
Practice Address - Street 1:300 S RHODES ST
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-4215
Practice Address - Country:US
Practice Address - Phone:870-400-0433
Practice Address - Fax:870-702-7069
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARC5250207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR101980001Medicaid
5-5545Medicare ID - Type Unspecified
AR101980001Medicaid