NPI 1174174502
Shane Lee Whiteside
Practice location
- Address
- 152 Highway 7 S, Oxford, MS 38655-5392
- Phone
- (662) 234-7521
- Fax
- (662) 236-3071
- Mailing address
- 5280 County Road 220, Water Valley, MS 38965-6221
Registered specialties
Peer Specialist
Primary
Registry record
- NPI
- 1174174502
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 26 Sep 2019
- Record last updated
- 26 Sep 2019
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.