Individual
MRS. JACQUELINE D SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3300 WILCOX BLVD, CHATTANOOGA, TN 37411-1073
(423) 493-2100
(423) 493-2137
Mailing address
3300 WILCOX BLVD, CHATTANOOGA, TN 37411-1073
(423) 493-2100
(423) 493-2137
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
19823
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3050365
—
TN
Enumeration date
08/30/2005
Last updated
10/05/2011
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