Healthcare Provider Details
I. General information
NPI: 1023029550
Provider Name (Legal Business Name): JAMES E SHUFFIELD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/10/2006
Last Update Date: 03/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10100 KANIS RD
LITTLE ROCK AR
72205-6202
US
IV. Provider business mailing address
10100 KANIS RD
LITTLE ROCK AR
72205-6202
US
V. Phone/Fax
- Phone: 501-255-6000
- Fax: 501-255-6400
- Phone: 501-255-6000
- Fax: 501-255-6400
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | C6882 |
| License Number State | AR |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0011X |
| Taxonomy | Interventional Cardiology Physician |
| License Number | C6882 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: