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General NPI Number Information
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NPI Number | 1417301417
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Entity Type | Individual
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Provider Name | SHAUN DANIEL ADAMS MD
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Gender | Male
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Dates
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Enumeration Date | 04/16/2016
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Last Update Date | 08/09/2019
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Provider Practice Location Address
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Address Line | 2710 S RIFE MEDICAL LN
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City | ROGERS
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State | AR
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Zip | 72758-1452
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Country | US
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Telephone | 479-338-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 1341 N FUTRALL DR APARTMENT 4
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-1172
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Country | US
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Telephone | 501-626-4477
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | E-12093
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License Number State | AR
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