Individual
SHANNON J. MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
878 LAKELAND DR, JACKSON, MS 39216-4644
(601) 984-6800
(601) 984-6811
Mailing address
PO BOX 4999, JACKSON, MS 39296-4999
(601) 984-5426
(601) 984-6889
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
829-L
MS
Other
Enumeration date
06/29/2012
Last updated
06/29/2012
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