Don Michael Shepherd, RPH

Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Waycross, GA

NPI 1114186129 · NPPES record last updated Jun 4, 2008

Key facts

NPI
1114186129
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
License
9971 (GA)
Practice address
1803 Knight Ave
Waycross, GA 31501-8018
Phone
(912) 285-4630
Fax
(912) 283-8929
NPI assigned
Jun 4, 2008
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
9971GAMDPhysician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 9971 GA Yes

Addresses

Primary practice location

1803 Knight Ave
Waycross, GA 31501-8018

Mailing address

1803 Knight Ave
Waycross, GA 31501-8018
Phone (912) 285-4630

Other providers in Waycross, GA

All providers in Waycross, GA · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Georgia

Sources for this page

Verify at the official NPI Registry.