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General NPI Number Information
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NPI Number | 1295745933
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Entity Type | Organization
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Legal Business Name | SHAWN PURIFOY, M.D., P.A.
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 850 HENRY ST
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City | MALVERN
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State | AR
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Zip | 72104-2712
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Country | US
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Telephone | 501-337-1836
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Fax | 501-337-7935
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Provider Business Mailing Address
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Address Line | 850 HENRY ST
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City | MALVERN
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State | AR
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Zip | 72104-2712
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Country | US
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Telephone | 501-337-1836
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Fax | 501-337-7935
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Authorized Official
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Title or Position | DOCTOR
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Name | SHAWN PURIFOY
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Credential | M.D.
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Telephone | 501-337-1836
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E0603
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License Number State | AR
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