Shores, Jennifer C

Shores, Jennifer C is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Cardiology, which is considered as her primary health care specialty. Shores, Jennifer C can be contacted via phone (601) 984-5250.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 984-5250
Fax: (601) 984-5283
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X 17022 Mississippi

Profile Details

NPI number 1568493450
LBN Legal business name Shores, Jennifer C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2006
Last updated Apr 21st, 2014 - about 11 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 1568493450 NPPES
Mississippi MEDICAID 0123172
Mississippi MEDICAID 158189

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