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NPI Code Detail

MEDICARE: DAVID JASON SHEHANE SR.

MEDICARE: DAVID JASON SHEHANE SR.
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
1171W00000XContractor

General Provider Information

NPI Number : 1235845116
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID JASON SHEHANE SR.
Provider Business Mailing Address
First Line : 4503 REESE RD APT 601
Second Line :
City : COLUMBUS
State : GA
Zip : 31907-1180
Country : US
Telephone Number : 706-315-8797
Fax Number :
Provider Business Practice Location Address
First Line : 4503 REESE RD APT 601
Second Line :
City : COLUMBUS
State : GA
Zip : 31907-1180
Country : US
Telephone Number : 706-315-8797
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2023
Last Update Date : 01/25/2023

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Directions to “ DAVID JASON SHEHANE SR. ” Practice Location

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