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General NPI Number Information
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NPI Number | 1417995457
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Entity Type | Individual
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Provider Name | MUHAMMAD YOUNUS SHAJAAT MD
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Gender | Male
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1400 BRADEN ST
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City | JACKSONVILLE
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State | AR
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Zip | 72076-3721
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Country | US
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Telephone | 800-893-9698
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 WELLINGTON WOODS DR
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City | LITTLE ROCK
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State | AR
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Zip | 72211-2077
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Country | US
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Telephone | 800-893-9698
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | E-3419
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License Number State | AR
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