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General NPI Number Information
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NPI Number | 1720044894
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Entity Type | Individual
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Provider Name | CLAUDETTE JONES SHEPHARD MD
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Gender | Female
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 02/01/2018
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Provider Practice Location Address
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Address Line | 880 MADISON AVE SUITE 3C
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City | MEMPHIS
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State | TN
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Zip | 38103-3409
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Country | US
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Telephone | 901-515-3800
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Fax | 901-302-2491
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Provider Business Mailing Address
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Address Line | 877 JEFFERSON AVE ATTN: PROVIDER ENROLLMENT
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City | MEMPHIS
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State | TN
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Zip | 38103-2807
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Country | US
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Telephone | 901-545-7302
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Fax |
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 21688
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License Number State | TN
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