Dr MARTY P. WITUCKI is a male medical professional, specializing in Psychologist, Clinical. He graduated in 1993.
SGOH ACQUISITION INC
1101 JACKSON ST SW
GRAVETTE
AR
727369121
Tel: 4797875291
| Npi | 1477587772 |
| Pac Id | 5799718243 |
| Professional Enrollment Id | I20180109003432 |
| Last Name | WITUCKI |
| First Name | MARTY |
| Middle Name | P. |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 1993 |
| Primary Specialty | PSYCHOLOGIST, CLINICAL |
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| Organization Legal Name | SGOH ACQUISITION INC |
| Group Practice Pac Id | 5092616276 |
| Number Of Group Practice Members | 49 |
| Line 1 Street Address | 1101 JACKSON ST SW |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | GRAVETTE |
| State | AR |
| Zip Code | 727369121 |
| Phone Number | 4797875291 |
| Hospital Affiliation Ccn 1 | 041331 |
| Hospital Affiliation Lbn 1 | OZARKS COMMUNITY HOSPITAL OF GRAVETTE |
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| Professional Accepts Medicare Assignment | Y |
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