Individual
DR. MARK D SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
670 CROSSOVER RD, TUPELO, MS 38801-4944
(662) 844-8414
(662) 844-7275
Mailing address
PO BOX 4087, TUPELO, MS 38803-4087
(662) 844-4911
(662) 844-8275
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
14824
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00116650
—
MS
01
—
460001322
RAILROAD MEDICARE
MS
01
—
CHO754
RAILROAD MEDICARE GROUP
MS
Enumeration date
08/02/2006
Last updated
03/04/2010
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