| Shannon Swift Cooper, MD | |
|
1309 W Main St, Walnut Ridge, AR 72476-1430 | |
| (870) 886-3211 | |
| (870) 886-3616 |
| Full Name | Shannon Swift Cooper |
|---|---|
| Gender | Female |
| Speciality | Internal Medicine |
| Experience | 16 Years |
| Location | 1309 W Main St, Walnut Ridge, Arkansas |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013141621 | NPI | - | NPPES |
| 296613 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | E8066 (Arkansas) | Secondary |
| 207R00000X | Internal Medicine | E8066 (Arkansas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lawrence Memorial Hospital | Walnut ridge, AR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lawrence Memorial Hospital | 9436052917 | 9 |
| Lawrence Memorial Health Foundation Inc | 9436305836 | 10 |
| Entity Name | Lawrence Memorial Health Foundation Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528052107 PECOS PAC ID: 9436305836 Enrollment ID: O20191029002135 |
| Entity Name | Lawrence Memorial Health Foundation Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962626770 PECOS PAC ID: 9436305836 Enrollment ID: O20191030002298 |
| Mailing Address | Practice Location Address |
|---|---|
| Shannon Swift Cooper, MD Po Box 839, Walnut Ridge, AR 72476-0839 Ph: (870) 886-3211 | Shannon Swift Cooper, MD 1309 W Main St, Walnut Ridge, AR 72476-1430 Ph: (870) 886-3211 |
Paul Vellozo, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1309 West Main St, Family Medical Center, Walnut Ridge, AR 72476 Phone: 870-886-3211 Fax: 870-886-9027 | |
Mrs. Samantha L. Hatfield, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1309 West Main Street, Walnut Ridge, AR 72476 Phone: 870-886-3211 Fax: 870-886-9027 |