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General NPI Number Information
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NPI Number | 1609979426
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Entity Type | Individual
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Provider Name | DARA M MOONEY PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 05/17/2013
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Provider Practice Location Address
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Address Line | 1003 SCHNEIDER DR
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City | MALVERN
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State | AR
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Zip | 72104-4811
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Country | US
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Telephone | 501-337-5678
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Fax | 501-332-6759
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Provider Business Mailing Address
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Address Line | 4301 W MARKHAM ST 783
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City | LITTLE ROCK
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State | AR
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Zip | 72205-7101
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Country | US
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Telephone | 501-686-7027
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Fax | 501-296-1307
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA-308
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License Number State | AR
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