Individual
JAMAL SHILLINGFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2 BON AIR RD STE 120, LARKSPUR, CA 94939-1142
(415) 927-5300
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 272-5063
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
51177
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300013826
—
IN
Enumeration date
04/15/2013
Last updated
08/20/2019
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