Individual
SONYA ROCHELLE SHIPLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, DEPT OF FAMILY MEDICINE, JACKSON, MS 39216-4500
(601) 815-4778
(601) 984-5420
Mailing address
2500 N STATE ST, DEPT OF FAMILY MEDICINE, JACKSON, MS 39216-4500
(601) 815-4778
(601) 984-5420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20879
MS
207Q00000X
Family Medicine Physician
48525
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06435092
—
MS
01
—
P01402396
RR MEDICARE
MS
Enumeration date
06/30/2008
Last updated
03/01/2016
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