Most Relevant Information
Provider Data
| NPI Number: | 1003351107 |
| Provider Name: | TIJUNA SHEPARD |
| Entity Type: | Individual |
| Taxonomy Code: | 1744P3200X |
| Specialty: | Specialist |
| License Number: | 122113 |
Most Important Dates
| Enumeration Date: | 12/27/2016 |
| Last Updated: | 12/27/2016 |
Provider Practice Location
7505 US HIGHWAY 64
SUITE 105
MEMPHIS
TN
381338947
Practice Location Phone/Fax
| Phone: | 9013472003 |
| Fax: |
Provider Mailing Location
7505 US HIGHWAY 64
SUITE 105
MEMPHIS
TN
381338947
Provider Mailing Phone/Fax
| Phone: | 9013472003 |
| Fax: |