Individual
TONY SHEPPARD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHD HSPP
Contact information
Practice address
335 SPRING ST, JEFFERSONVILLE, IN 47130-4480
(812) 258-0310
(812) 258-0409
Mailing address
720 N MARR RD, COLUMBUS, IN 47201-6660
(812) 314-3400
(812) 378-8367
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041852A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000320601
ANTHEM PIN
IN
Enumeration date
03/09/2006
Last updated
07/08/2007
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