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NPI Code Detail

MEDICARE: RON SHEPPARD OT

MEDICARE:   RON  SHEPPARD  OT
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
1224Z00000XOccupational Therapy AssistantOT00361TN
2225X00000XOccupational Therapist0119001450VA
3225X00000XOccupational Therapist361TN

General Provider Information

NPI Number : 1831193796
Entity Type Code : Individual
Provider Name (Legal Business Name) : RON SHEPPARD OT
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : HOOVER
State : AL
Zip : 35242-5424
Country : US
Telephone Number : 423-238-7568
Fax Number : 276-386-1446
Provider Business Practice Location Address
First Line : 2817 W ANDREW JOHNSON HWY
Second Line :
City : MORRISTOWN
State : TN
Zip : 37814-3216
Country : US
Telephone Number : 423-586-4810
Fax Number : 276-386-1446
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 01/19/2022

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