Shann, Timothy Ray

Shann, Timothy Ray is an individual health care provider with primary practice located at 509 Brookman Dr , Brookhaven MS 39601-2326. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Shann, Timothy Ray can be contacted via phone (601) 823-5204.

Contact Information

Primary practice address
509 Brookman Dr Brookhaven MS 39601-2326
Phone: (601) 823-5204
Fax: (601) 833-1224
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 21817 Oklahoma

Profile Details

NPI number 1477518793
LBN Legal business name Shann, Timothy Ray
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2006
Last updated Oct 25th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477518793 NPPES
Oklahoma Other 731310891006 UNICARE
Oklahoma Other 731310891028 UNICARE
Oklahoma MEDICAID 100253110A UNICARE
Oklahoma Other 100253110A UNICARE
Oklahoma Other 74502A041 UNICARE

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