Provider Demographics
NPI:1750488953
Name:NORTH CABOT FAMILY MEDICINE PA
Entity type:Organization
Organization Name:NORTH CABOT FAMILY MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FLOYD
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHURLEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:501-843-5757
Mailing Address - Street 1:PO BOX 1265
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-1265
Mailing Address - Country:US
Mailing Address - Phone:501-843-5757
Mailing Address - Fax:501-843-5700
Practice Address - Street 1:1911 N 2ND ST
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-2209
Practice Address - Country:US
Practice Address - Phone:501-843-5757
Practice Address - Fax:501-843-5700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5C486Medicare ID - Type UnspecifiedGROUP NUMBER