NPI 1275939639

Shundobie T Coleman

Practitioner Contractor Jackson, MS

Practice location

Address: 199 Raymond Rd STE D, Jackson, MS 39204-2864
Phone: (800) 807-4858
Fax: (800) 313-1036

Registered specialties (2)

Contractor Primary

Other Service Providers Taxonomy 171W00000X

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Driver

Other Service Providers Taxonomy 172A00000X

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Registry record

NPI: 1275939639
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Nov 2014
Record last updated: 21 Sep 2016

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.