Individual
SHANNON SWIFT COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1309 W MAIN ST, WALNUT RIDGE, AR 72476-1430
(870) 886-3211
(870) 886-3616
Mailing address
PO BOX 839, WALNUT RIDGE, AR 72476-0839
(870) 886-3211
(870) 886-3616
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E8066
AR
208000000X
Pediatrics Physician
E8066
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
296613
—
AR
Enumeration date
05/11/2009
Last updated
12/27/2022
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