Shaddox, Truman Stephen

Shaddox, Truman Stephen is an individual health care provider with primary practice located at 12 E Appleby Rd Ste 101, Fayetteville AR 72703-3901. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Shaddox, Truman Stephen can be contacted via phone (479) 463-4444.

Contact Information

Primary practice address
12 E Appleby Rd Ste 101 Fayetteville AR 72703-3901
Phone: (479) 463-4444
Fax: (479) 463-4499
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X C-4757 Arkansas

Profile Details

NPI number 1649236951
LBN Legal business name Shaddox, Truman Stephen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2006
Last updated Apr 22nd, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649236951 NPPES
Arkansas MEDICAID 106393001

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