Individual
DR. AMY BALDUCCI SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2000
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2000
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
18335
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00121927
—
MS
05
—
1461032
—
LA
Enumeration date
06/15/2006
Last updated
06/12/2012
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