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General NPI Number Information
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NPI Number | 1205977196
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Entity Type | Organization
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Legal Business Name | ARKANSAS CENTER FOR WOMEN, LTD
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1609 W 40TH AVE SUITE 203
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City | PINE BLUFF
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State | AR
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Zip | 71603-6319
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Country | US
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Telephone | 840-534-4900
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Fax | 870-534-8341
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Provider Business Mailing Address
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Address Line | 1609 W 40TH AVE SUITE 203
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City | PINE BLUFF
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State | AR
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Zip | 71603-6319
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Country | US
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Telephone | 840-534-4900
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Fax | 870-534-8341
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Authorized Official
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Title or Position | PRESIDENT
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Name | KELLY DEAN SHRUM
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Credential | D.O.
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Telephone | 870-534-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | E0704
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License Number State | AR
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