Provider Demographics
NPI:1417943150
Name:WEWERS, DARIN A (MD)
Entity Type:Individual
Prefix:
First Name:DARIN
Middle Name:A
Last Name:WEWERS
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 1:500 S UNIVERSITY AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5307
Mailing Address - Country:US
Mailing Address - Phone:501-664-4532
Mailing Address - Fax:501-663-4335
Practice Address - Street 1:2 SAINT VINCENT CIR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5423
Practice Address - Country:US
Practice Address - Phone:501-664-4532
Practice Address - Fax:501-663-4335
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-1784207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR171973300OtherUS DEPT. OF LABOR OWCP
AR17993000020OtherQUAL CHOICE (LRPM)
AR050060633OtherRAILROAD MEDICARE (LRPM)
AR050060657OtherRAILROAD MEDICARE
AR71033532430OtherQUAL CHOICE
AR134522001Medicaid
AR5K816OtherBLUE CROSS BLUE SHIELD
AR770132301OtherARKANSAS BREASTCARE
ARS01177OtherNOVASYS
AR134522001Medicaid