Organization
FORT SMITH NEUROSCIENCE CENTER, PLLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN P MOORE M.D. (OWNER)
(479) 434-3544
Entity
Organization
Contact information
Practice address
7217 CAMERON PARK DRIVE, FORT SMITH, AR 72903
(479) 434-3544
(479) 434-3547
Mailing address
PO BOX 180969, FORT SMITH, AR 72918-0969
(479) 434-3544
(479) 434-3547
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E6954
AR
Other
Enumeration date
09/09/2013
Last updated
12/03/2014
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