Individual
SHANNON WIPF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1615 W PERSIMMON ST, ROGERS, AR 72756-3359
(479) 636-7192
Mailing address
1615 W PERSIMMON ST, ROGERS, AR 72756-3359
(479) 636-7192
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
C172750
CA
207Q00000X
Family Medicine Physician
Primary
E3256
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146562001
—
AR
Enumeration date
06/03/2006
Last updated
11/11/2025
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