Individual
TIMOTHY RAY SHANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
509 BROOKMAN DR, BROOKHAVEN, MS 39601-2326
(601) 823-5204
(601) 833-1224
Mailing address
509 BROOKMAN DR, BROOKHAVEN, MS 39601-2326
(601) 823-5204
(601) 833-1224
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
21817
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100253110A
SOONER PCP
OK
05
—
100253110A
—
OK
01
—
731310891006
UNICARE
OK
01
—
731310891028
TRICARE SOUTH
OK
01
—
74502A041
CHAMPUS (WPS)
OK
Enumeration date
04/19/2006
Last updated
10/25/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us