Individual
JERRY M SHEPPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, DEPT OF MEDICINE DIVISION OF GENERAL INTERNAL MEDICINE, JACKSON, MS 39225-4146
(601) 984-2746
(601) 984-6870
Mailing address
2500 N STATE ST, HOSPITALIST, JACKSON, MS 39216-4500
(601) 984-6426
(601) 984-6439
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18932
MS
208M00000X
Hospitalist Physician
18932
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06356838
—
MS
05
—
154127
—
MS
Enumeration date
08/09/2006
Last updated
04/10/2014
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