| Riley Carlton Wade Grogan, | |
|
104 W State St, Caraway, AR 72419-8553 | |
| (870) 956-0200 | |
| Not Available |
| Full Name | Riley Carlton Wade Grogan |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Location | 104 W State St, Caraway, Arkansas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477437283 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 232785 (Arkansas) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Riley Carlton Wade Grogan, 4196 Highway 62 412 Ste A, Hardy, AR 72542-8002 Ph: (870) 856-2100 | Riley Carlton Wade Grogan, 104 W State St, Caraway, AR 72419-8553 Ph: (870) 956-0200 |
Charity Angela Lane, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 104 West State St, Caraway, AR 72419 Phone: 870-956-0200 Fax: 870-895-2164 | |
April Ann Nutt, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 104 W State St, Caraway, AR 72419 Phone: 870-565-9205 Fax: 870-895-2164 |