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NPI Code Detail

MEDICARE: JOHN GARY SHULER L.C.S.W.

MEDICARE:   JOHN GARY SHULER  L.C.S.W.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker1570-CAR

General Provider Information

NPI Number : 1073638755
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN GARY SHULER L.C.S.W.
Provider Business Mailing Address
First Line : 221 N EAST AVE
Second Line : SUITE 206
City : FAYETTEVILLE
State : AR
Zip : 72701-5226
Country : US
Telephone Number : 479-871-8751
Fax Number :
Provider Business Practice Location Address
First Line : 221 N EAST AVE
Second Line : 206
City : FAYETTEVILLE
State : AR
Zip : 72701-5226
Country : US
Telephone Number : 479-871-8751
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 07/25/2012

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Directions to “ JOHN GARY SHULER L.C.S.W.” Practice Location

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