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Individual

MR. JONATHAN MICHAEL SHULTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD.

Contact information

Practice address
6715 FOREST PARK DR, SAVANNAH, GA 31406-2507
(912) 777-6920
(912) 777-4018
Mailing address
6715 FOREST PARK DR, SAVANNAH, GA 31406-2507
(912) 777-6920
(912) 777-4018

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
024049
LA
207X00000X
Orthopaedic Surgery Physician
Primary
75377
GA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
75377
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1422649
LA
Enumeration date
09/15/2006
Last updated
10/12/2021
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