Healthcare Provider Details

I. General information

NPI: 1669430286
Provider Name (Legal Business Name): STEVEN M SHRUM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 02/06/2020
Certification Date: 02/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 N MAIN ST
HARRISON AR
72601-2914
US

IV. Provider business mailing address

825 N MAIN ST
HARRISON AR
72601
US

V. Phone/Fax

Practice location:
  • Phone: 870-743-4900
  • Fax: 870-743-4949
Mailing address:
  • Phone: 870-743-4900
  • Fax: 870-743-4949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberE3565
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE3565
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: