Individual
DAVID SHROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
971 LAKELAND DR STE 356, JACKSON, MS 39216-4607
(601) 200-4644
(601) 200-4645
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(601) 200-4644
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00333
MS
363AM0700X
Medical Physician Assistant
1234567890
VA
Other
Enumeration date
03/24/2016
Last updated
02/09/2024
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