Organization
SHIROLYN MOFFETT M.D.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIROLYN RUTH MOFFETT M.D. (PRESIDENT)
(870) 204-5129
Entity
Organization
Contact information
Practice address
715 W SHERMAN AVE, SUITE D, HARRISON, AR 72601-2743
(870) 204-5129
(870) 204-5131
Mailing address
715 W SHERMAN AVE, SUITE D, HARRISON, AR 72601-2743
(870) 204-5129
(870) 204-5131
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
E0693
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131508001
—
AR
Enumeration date
06/03/2010
Last updated
06/03/2010
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