Shannon, Angela B.

Shannon, Angela B. is an individual health care provider with primary practice located at 1679 Old Fannin Rd Ste E , Flowood MS 39232-8101. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Gastroenterology, which is considered as her primary health care specialty. Shannon, Angela B. can be contacted via phone (601) 398-1949.

Contact Information

Primary practice address
1679 Old Fannin Rd Ste E Flowood MS 39232-8101
Phone: (601) 398-1949
Fax: (769) 216-3044
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X 22009 Mississippi

Profile Details

NPI number 1407067739
LBN Legal business name Shannon, Angela B.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2007
Last updated Jul 12th, 2021 - about 3 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 1407067739 NPPES
Mississippi MEDICAID 05307227

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