Conner, Shavetta D

Conner, Shavetta D is an individual health care provider with primary practice located at 295 Summar Ave , Jackson TN 38301. She recently has only one registered license in Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine, which is considered as her primary health care specialty. Conner, Shavetta D can be contacted via phone (731) 421-6703.

Contact Information

Primary practice address
295 Summar Ave Jackson TN 38301
Phone: (731) 421-6703
Fax: (731) 935-7093
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine 2083P0901X 0000024830 Tennessee

Profile Details

NPI number 1235283623
LBN Legal business name Conner, Shavetta D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 22nd, 2007
Last updated Jul 26th, 2013 - 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 1235283623 NPPES
Tennessee MEDICAID 3897153

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