Individual
DR. JOHN DANIEL SHEPPARD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
241 CORPORATE BLVD, NORFOLK, VA 23502-4954
(757) 622-2200
(757) 622-4866
Mailing address
241 CORPORATE BLVD, SUITE 210, NORFOLK, VA 23502-4975
(757) 622-2200
(757) 622-4866
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101043383
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295959
CIGNA
VA
01
—
15830
OPTIMA
VA
01
—
1588663702
VIRGINIA PREMIER
VA
01
—
180015712
RR MEDICARE
VA
01
—
332514
ANTHEM BCBS
VA
05
—
6906436
—
NC
Enumeration date
07/19/2005
Last updated
10/14/2015
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