Individual
JACK B SHUMATE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 DOCTORS DR, STE B, PANAMA CITY, FL 32405-7609
(850) 872-1300
(850) 872-9420
Mailing address
100 DOCTORS DR, STE B, PANAMA CITY, FL 32405-7609
(850) 872-1300
(850) 872-9420
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME21390
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
68004
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/14/2005
Last updated
07/08/2007
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