Provider Demographics
NPI:1831371335
Name:W J ASHABRANNER MD PA
Entity type:Organization
Organization Name:W J ASHABRANNER MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ASHABRANNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-362-7538
Mailing Address - Street 1:106 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:HEBER SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72543-3715
Mailing Address - Country:US
Mailing Address - Phone:501-362-7538
Mailing Address - Fax:
Practice Address - Street 1:106 S 7TH ST
Practice Address - Street 2:
Practice Address - City:HEBER SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72543-3715
Practice Address - Country:US
Practice Address - Phone:501-362-7538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR043804Medicare Oscar/Certification