Mandy Suzanne Mooneyham in Fayetteville - Surgical
Mandy Suzanne Mooneyham - NPI 1831391655
Mandy Suzanne Mooneyham is a Surgical in Fayetteville, Arkansas. Mandy Suzanne Mooneyham practices all healthcare services and medical treatments related to Surgical. The NPI Number for Mandy Suzanne Mooneyham is 1831391655. The last update date is 2013-11-22.
Mandy Suzanne Mooneyham's current location address is 3053 N College Ave, Fayetteville, Arkansas. You can contact this provider via phone number 4794632000 and fax number 4794424518. The mailing address for Mandy Suzanne Mooneyham is 3053 N College Ave, Fayetteville, Arkansas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mandy Suzanne Mooneyham |
|---|---|
| Address | 3053 N College Ave, Fayetteville, Arkansas |
| Phone Number | 4794632000 |
| Fax Number | 4794424518 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1831391655 |
|---|---|
| Provider Enumeration Date | 2007-06-04 |
| Last Updated Date | 2013-11-22 |
Provider Mailing Address Detail
| Address | 3053 N College Ave |
|---|---|
| City | Fayetteville |
| State | Arkansas (AR) |
| Post Code | 727033417 |
| Phone Number | 4794632000 |
| Fax Number | 4794424518 |
Provider's Primary Taxonomy Detail
| Speciality | Surgical |
|---|---|
| Taxonomy | 363As0400X |
| Licence No | PA-329 |
|
Definition: A licensed healthcare professional who assists in providing surgical care under physician supervision. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 219705 | MO | BLUE CROSS/BLUE SHIELD | |
| 502277007 | MO | -- | |
| 223808 | WA | DEPARTMENT OF LABOR WA |
Post Comment/ Review Below
What is the Mandy Suzanne Mooneyham's unique identification number?
The Mandy Suzanne Mooneyham has been assigned the NPI (National Provider Identifier) Number 1831391655 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please provide the complete physical location address of Mandy Suzanne Mooneyham?
The Mandy Suzanne Mooneyham is physically situated at 3053 N College Ave, in the city of Fayetteville, state of AR, with the postal code 727033417.
What is Mandy Suzanne Mooneyham's specialized field of practice, and what is the corresponding taxonomy classification code?
The Mandy Suzanne Mooneyham's area of specialization is Surgical, and the corresponding taxonomy code that categorizes this field of practice is 363As0400X.
When was the Mandy Suzanne Mooneyham's 1831391655 issued?
The Mandy Suzanne Mooneyham's 1831391655 was issued on 2007-06-04.
When was the Mandy Suzanne Mooneyham's information last updated?
The Mandy Suzanne Mooneyham's information was last updated on 2013-11-22.