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General NPI Number Information
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NPI Number | 1942498134
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Entity Type | Organization
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Legal Business Name | F E SHEPARD JR MD PC
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Dates
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Enumeration Date | 10/12/2007
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 1412 PARK AVE NW
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City | NORTON
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State | VA
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Zip | 24273-1602
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Country | US
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Telephone | 276-679-7600
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Fax | 276-679-0738
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Provider Business Mailing Address
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Address Line | 1412 PARK AVE NW PO BOX 681
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City | NORTON
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State | VA
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Zip | 24273-1602
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Country | US
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Telephone | 276-679-7600
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Fax | 276-679-0738
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Authorized Official
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Title or Position | OWNER
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Name | DR. FELIX E. SHEPARD JR.
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Credential |
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Telephone | 276-679-7600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 208800000X
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License Number State | VA
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