Individual
DR. SHANNON R. CARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
207 CARTER ST, BERRYVILLE, AR 72616-4303
(870) 423-6661
(870) 423-4374
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R6D08
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101382001
—
AR
05
—
201729902
—
MO
01
—
50909
AR BLUE SHIELD #
AR
Enumeration date
10/14/2006
Last updated
07/09/2007
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