Individual
DR. SHEON H MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
969 LAKELAND DR, JACKSON, MS 39216-4606
(601) 200-4644
(601) 200-5929
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 200-4749
(601) 200-5929
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
255655
NY
208000000X
Pediatrics Physician
255655
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03976531
—
MS
01
—
P01232541
RAILROAD MEDICARE
MS
Enumeration date
12/21/2009
Last updated
05/25/2016
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