Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 52139 | TN |
Y | 207P00000X | Emergency Physician | E-9467 | AR |
NPI | 1013350255 |
---|---|
Provider Name | Dr. Craig Anthony Sheedy |
First Address | Springdale, AR 72764-5335 |
Second Address | Springdale, AR 72764-5335 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2013 |
Last Update Date | 23/12/2018 |