Healthcare Provider Details

I. General information

NPI: 1952223760
Provider Name (Legal Business Name): SHEPHERD HEARING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 OLD MCINTOSH RD
COLLINS MS
39428-6371
US

IV. Provider business mailing address

215 OLD MCINTOSH RD
COLLINS MS
39428-6371
US

V. Phone/Fax

Practice location:
  • Phone: 228-224-2833
  • Fax:
Mailing address:
  • Phone: 228-224-2833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: KYLE ROBERT SHEPHERD
Title or Position: HEARING INSTRUMENT SPECIALIST
Credential: HIS
Phone: 228-224-2833