Shields, Ted
Shields, Ted is an sole proprietor health care provider with primary practice located at 1710 Mayfield Drive , Jonesboro AR 72401. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Shields, Ted can be contacted via phone (844) 215-0731.Contact Information
Primary practice address
1710 Mayfield Drive
Jonesboro AR 72401
Phone: (844) 215-0731
Fax: (888) 630-8885
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medical Services | 207PE0004X | E3420 | Arkansas |
| Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine | 2083P0011X | E3420 | Arkansas |
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | E3420 | Arkansas |
Profile Details
| NPI number | 1972666147 |
|---|---|
| LBN Legal business name | Shields, Ted |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 19th, 2006 |
| Last updated | May 27th, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972666147 | NPPES |
| Arkansas | Other | E3420 | STATE LICENSE |
| Arkansas | MEDICAID | 148797003 | STATE LICENSE |
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