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Individual

WILLIAM R SHEPARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1139 3RD ST, SOUTH LAKE TAHOE, CA 96150
(530) 543-5691
(530) 542-2872
Mailing address
1111 EMERALD BAY RD, SOUTH LAKE TAHOE, CA 96150-6207
(530) 543-5659
(530) 541-8723

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
20A16448
CA
208600000X
Surgery Physician
DO2454
NV

Other

Enumeration date
06/12/2012
Last updated
08/28/2018
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