Individual
EDDIE W SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5 EXECUTIVE CENTER CT, LITTLE ROCK, AR 72211-4375
(501) 227-5210
(855) 656-7325
Mailing address
9800 SHELBYVILLE RD, STE 220, LOUISVILLE, KY 40223-2992
(502) 429-8585
(502) 429-6157
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
N-8292
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129121001
—
AR
01
—
A008
CHAMPUS
AR
Enumeration date
01/19/2006
Last updated
07/20/2020
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