Individual
MR. JERRY EMERSON SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3980 NEW COVINGTON PIKE STE 200, MEMPHIS, TN 38128-2514
(901) 937-3232
(901) 373-0804
Mailing address
5705 STAGE RD, STE 240, BARTLETT, TN 38134-4541
(901) 382-2606
(901) 373-0809
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
815
TN
Other
Enumeration date
01/23/2008
Last updated
09/01/2009
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