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General NPI Number Information
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NPI Number | 1225357189
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Entity Type | Individual
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Provider Name | JEFFREY SHEPHERD MD
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Gender | Male
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Dates
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Enumeration Date | 05/18/2010
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Last Update Date | 10/18/2023
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Provider Practice Location Address
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Address Line | 9828 E SHANNON WOODS CIR # 100
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City | WICHITA
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State | KS
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Zip | 67226-4100
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Country | US
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Telephone | 316-631-1600
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Fax | 316-631-1665
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Provider Business Mailing Address
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Address Line | 9828 E SHANNON WOODS CIR # 100
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City | WICHITA
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State | KS
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Zip | 67226-4100
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Country | US
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Telephone | 316-631-1600
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Fax | 316-631-1665
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | 04-39108
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 04-39108
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License Number State | KS
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