# JACK B SHUMATE M D P A

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790847077
- **Authorized official:** DR. JACK B SHUMATE (PHYSICIAN)
- **Authorized official phone:** (850) 872-1300

## Contact information

- **Practice address:** 100 DOCTORS DR, STE. B, PANAMA CITY, FL 32405-7608
- **Practice address phone:** (850) 872-1300
- **Practice address fax:** (850) 872-9420
- **Mailing address:** 100 DOCTORS DR, STE. B, PANAMA CITY, FL 32405-7608
- **Mailing address phone:** (850) 872-1300
- **Mailing address fax:** (850) 872-9420

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | ME21390 | FL | Yes |

## Other

- **Enumeration date:** 12/14/2006
- **Last updated:** 08/22/2020