Shearer, Jack R

Shearer, Jack R is an individual health care provider with primary practice located at 262 Danny Thomas Pl , Memphis TN 38105-3678. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Shearer, Jack R can be contacted via phone (901) 595-3006.

Contact Information

Primary practice address
262 Danny Thomas Pl Memphis TN 38105-3678
Phone: (901) 595-3006
Fax: (901) 595-3842
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 144583 Tennessee

Profile Details

NPI number 1265438980
LBN Legal business name Shearer, Jack R
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2005
Last updated Oct 2nd, 2012 - about 12 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 1265438980 NPPES
Louisiana MEDICAID 1472115
Louisiana MEDICAID 174264501
Louisiana MEDICAID 04132040
Louisiana MEDICAID 422400000
Louisiana MEDICAID 104694231
Louisiana MEDICAID 919333104
Louisiana MEDICAID 4307498
Louisiana MEDICAID QAN028
Louisiana MEDICAID 010133181
Louisiana MEDICAID 200055730A
Louisiana MEDICAID 200522250A
Louisiana MEDICAID 2524076
Louisiana MEDICAID 9572
Louisiana MEDICAID 157589001
Louisiana MEDICAID 5440235

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