Individual
MS. JASMINE DONESHA SHACKELFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
915 W GORDON ST, THOMASTON, GA 30286-3427
(706) 647-7009
Mailing address
915 W GORDON ST, THOMASTON, GA 30286-3427
(706) 647-7009
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
95589
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2020
Last updated
06/29/2023
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