Organization
MILTON W SHEPPERD, DO, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILTON SHEPPERD DO (PRESIDENT)
(512) 508-4312
Entity
Organization
Contact information
Practice address
113 BROADMOOR ST, MEADOWLAKES, TX 78654-6601
(830) 693-1792
(830) 693-1685
Mailing address
PO BOX 1930, MARBLE FALLS, TX 78654-2680
(830) 693-1792
(830) 693-1685
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
J6722
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0068AA
BCBS
—
05
—
176966301
—
TX
01
—
DG9173
RAILROAD MEDICARE
—
Enumeration date
01/11/2010
Last updated
01/11/2010
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