Charles Earl Wall JR., PA-C
NPI #1013178128 in Fayetteville, Arkansas
Provider Information
- NPI Number
- 1013178128
- Entity Type
- Individual
- Name
- Charles Earl Wall JR., PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Jun 20, 2008
- Last Updated
- Mar 7, 2023
Practice Location
- Address
- 1100 N COLLEGE AVE
- City
- Fayetteville
- State
- Arkansas
- ZIP Code
- 72703-1944
- Phone
- (479) 443-4301
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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