Good Shepherd Medical/Dental Clinic

Primary specialty

Specialty PharmacyTaxonomy code 3336S0011X

Legal business name

GOOD SHEPHERD MEDICAL/DENTAL CLINIC

Doing business as

Good Shepherd Clinic

Practice address

207 S 11TH Ave
Laurel, MS 39440-4314

Phone

(601) 426-2001

Fax

(601) 426-2002

NPI assigned

May 25, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. David Wolgamott

Title

Office Manager

Phone

(601) 426-2001

Specialties & licenses 1

Addresses

Other names 1

• Good Shepherd Clinic Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1770158339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2704",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394422704",
            "telephone_number": "601-426-2001",
            "fax_number": "601-426-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 S 11TH AVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404314",
            "telephone_number": "601-426-2001",
            "fax_number": "601-426-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SHEPHERD MEDICAL/DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "WOLGAMOTT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-426-2001",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Shepherd Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialty Pharmacy in Laurel, MS
• Providers in Laurel, MS by specialty
• Specialty Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.