Shaw, Jacqueline D

Shaw, Jacqueline D is an individual health care provider with primary practice located at 3300 Wilcox Blvd , Chattanooga TN 37411-1073. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Shaw, Jacqueline D can be contacted via phone (423) 493-2100.

Contact Information

Primary practice address
3300 Wilcox Blvd Chattanooga TN 37411-1073
Fax: (423) 493-2137
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 19823 Tennessee

Profile Details

NPI number 1598758021
LBN Legal business name Shaw, Jacqueline D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2005
Last updated Oct 5th, 2011 - about 13 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 1598758021 NPPES
Tennessee MEDICAID 3050365

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