Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 29074 | AZ |
N | 207XS0106X | Orthopaedic Hand Surgeon | 29074 | AZ |
NPI | 1114098472 |
---|---|
Provider Name | Joseph E Sheppard |
First Address | Tucson, AZ 85704-5822 |
Second Address | Tucson, AZ 85711-2683 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
553538 | (05) | AZ |
B56569 | (02) |