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SHAWN PURIFOY M.D. P.A. NPI 1295745933


NPI Information

NPI: 1295745933
Provider Name: SHAWN PURIFOY, M.D., P.A.

Doing Business As: MALVERN FAMILY MEDICAL CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 04D1049900

Address:
850 HENRY ST
MALVERN, AR
ZIP 72104
Phone: (501) 337-1836
Get Directions

SHAWN PURIFOY, M.D., P.A. is a family medicine in Malvern, AR. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SHAWN PURIFOY, M.D., P.A. NPI is 1295745933. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Malvern Family Medical Clinic.

The provider's business location address is:

850 HENRY ST
MALVERN, AR
ZIP 72104-712
Phone: (501) 337-1836
Fax: (501) 337-7935

The provider's authorized official is Shawn Purifoy .
The authorized official title is Doctor and has the following contact phone number (501) 337-1836.

The CLIA number assigned to this NPI record is 04D1049900 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/8/2006 and was last updated on 6/13/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineE0603ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1160100002MEDICAIDARKANSAS
2G12502MEDICARE UPINARKANSAS
35F472MEDICARE ID-TYPE UNSPECIFIEDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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