Organization
N/A
Active
Organization
N/A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAWN MICHAEL RICHARD MD (PHYSICIAN)
(501) 803-3418
Entity
Organization
Contact information
Practice address
6814 PRINCETON PIKE, PINE BLUFF, AR 71602-9411
(501) 353-3765
Mailing address
PO BOX 13585, MAUMELLE, AR 72113-0585
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
022748
LA
273R00000X
Psychiatric Hospital Unit
Primary
E-5344
AR
Other
Enumeration date
02/20/2015
Last updated
02/20/2015
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