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NPI Code Detail

MEDICARE: DR. SHUNDA LYNETTE GARNER MD

MEDICARE: DR. SHUNDA LYNETTE GARNER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician16790MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124017546
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHUNDA LYNETTE GARNER MD
Provider Business Mailing Address
First Line : 278 DINKENS RD
Second Line :
City : PICKENS
State : MS
Zip : 39146-9587
Country : US
Telephone Number : 601-672-7274
Fax Number :
Provider Business Practice Location Address
First Line : 8613 MS HIGHWAY 12
Second Line :
City : ACKERMAN
State : MS
Zip : 39735-8917
Country : US
Telephone Number : 662-285-4400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2005
Last Update Date : 03/10/2020

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