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Individual

MS. LISA ANN SCHAFER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
3900 PETRO RD, STE 11, WEST MEMPHIS, AR 72301
(870) 732-0332
(870) 732-3078
Mailing address
3900 PETRO RD, STE 11, WEST MEMPHIS, AR 72301
(870) 732-0332
(870) 732-3078

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
AO1128
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5Y635
BLUE CROSS PTAN
AR
Enumeration date
02/13/2008
Last updated
02/13/2008
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