person
Mandy Suzanne Mooneyham, PA-C
Surgical Physician Assistant in Fayetteville, Arkansas
NPI 1831391655

Mandy Suzanne Mooneyham is a Surgical Physician Assistant based in Fayetteville, AR and is specialized in Surgical. Mandy Suzanne Mooneyham practices in Fayetteville, AR and has the professional credentials of PA-C. The NPI Number for Mandy Suzanne Mooneyham is 1831391655 and holds a License No. PA-329 (Arkansas).

The current practice location address for Mandy Suzanne Mooneyham is 3053 N College Ave, Fayetteville, AR and can be reached out via phone at 479-463-2000 and via fax at 479-442-4518.

Location: 3053 N College Ave, Fayetteville, AR, 72703-3417
person
Provider Profile Details
NPI Number
1831391655
Provider Name
Mandy Suzanne Mooneyham
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
3053 N College Ave, Fayetteville, AR, 72703-3417
Phone Number
479-463-2000
Fax Number
479-442-4518
Provider Enumeration Date
06/04/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
219705 01 MO BLUE CROSS/BLUE SHIELD
502277007 05 MO
0223808 01 WA DEPARTMENT OF LABOR WA
institution
Provider Business Practice Location Address Details
Address
3053 N College Ave
City
State
Zip
72703-3417
Phone Number
479-463-2000
Fax Number
479-442-4518
person
Provider Business Mailing Address Details
Address
3053 N College Ave
City
State
Zip
72703-3417
Phone Number
479-463-2000
Fax Number
479-442-4518
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
PA-329 (Arkansas)
Definition
Definition to come...
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