| Shaneyfelt Clinic | |
|
105 S. Baltimore Manila AR 72442-0630 | |
| (870) 561-4421 | |
| (870) 561-3434 |
| Full Name | Shaneyfelt Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 105 S. Baltimore, Manila, Arkansas |
| Authorized Official Name and Position | Dora Elizabeth Shaneyfelt (OWNER AND ADVANCED PRACTICE NURSE) |
| Authorized Official Contact | 8705614421 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shaneyfelt Clinic Po Box 630 105 South Baltimore Street Manila AR 72442-0630 Ph: (870) 561-4421 | Shaneyfelt Clinic 105 S. Baltimore Manila AR 72442-0630 Ph: (870) 561-4421 |
| NPI Number | 1124175773 |
|---|---|
| Provider Enumeration Date | 01/05/2007 |
| Last Update Date | 05/24/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124175773 | NPI | - | NPPES |
| 162966002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
T W Wagner Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3644 W State Highway 18, Manila, AR 72442 Phone: 870-561-3300 Fax: 870-561-3307 | |
Wagner Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3644 W State Highway 18, Manila, AR 72442 Phone: 870-561-3300 Fax: 870-561-3307 |