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Individual

MR. JOSEPH EDWARD SHAMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BE BOCO, LPOA

Contact information

Practice address
3500 S 79TH ST STE A, FORT SMITH, AR 72903-6250
(479) 484-1620
(479) 484-1619
Mailing address
3500 S 79TH ST STE A, FORT SMITH, AR 72903-6250
(479) 484-1620
(479) 484-1619

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
OPPA0006
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OPPA0006
ARKANSAS BOARD OF MEDICAL LICENSING FOR O&P
AR
Enumeration date
04/27/2012
Last updated
07/09/2012
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