MR. AUNDRAY TERALL SHACKELFORD


Address: 105 Rankin Blvd Ext, Tupelo, MS 38801-4611
Phone: 6622601239

MR. AUNDRAY TERALL SHACKELFORD (NPI# 1023653714) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1023653714
Entity Type Individual
Full Name MR. AUNDRAY TERALL SHACKELFORD
Credential PROSTHETICSPECIALIST
Practice Address 105 Rankin Blvd Ext
Tupelo
MS 38801-4611
Mailing Address 204 City Point Rd
Tupelo
MS 38801-8637
Practice Telephone 6622601239
Mailing Telephone 6622601239
Enumeration Date 2019-11-17
Last Update Date 2019-11-17
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1744P3200X Specialist
Specialization: Prosthetics Case Management
Other Service Providers

Office Location

Street Address 105 RANKIN BLVD EXT
City TUPELO
State MS
Zip Code 38801-4611

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1194339275 Friendship, LLC Pharmacy 4123 W Main St, Tupelo, MS 38801 2020-09-04
1003443458 Nicole Sherice Taylor Nurse Practitioner 845 South Gloster Street, Tupelo, MS 38801 2020-03-25
1821556838 Wilco Healthcare of North Mississippi, Pllc Point of Service 1514 Co Rd 41, Tupelo, MS 38801 2019-03-08
1821565235 Stephanie K Cagle Nurse Practitioner 218 S Thomas St Ste 120-121, Tupelo, MS 38801 2018-10-24
1073092326 Lauren Parrish Nurse Practitioner 1573 Medical Park Circle, Tupelo, MS 38801 2018-08-08
1467948687 North Mississippi Medcial Center, Inc. Nurse Practitioner 990 S Madison St Ste 2, Tupelo, MS 38801 2018-07-11
1043700933 Hooks Diabetes & Medicine Clinic Non-Pharmacy Dispensing Site 2610 Traceland Drive, Ste A, Tupelo, MS 38801 2018-05-16
1073035903 Annette C Riddle Counselor 1004 Eisenhower Drive, Tupelo, MS 38801 2017-07-12
1548709678 Jaime Summers Nurse Practitioner 2780 West Jackson St, Tupelo, MS 38801 2017-02-22
1073975611 Heath Bryan Coleman, Dds of Mississippi II, Pllc Dentist 1168 Cross Creek Drive, Tupelo, MS 38801 2016-03-23
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Taxonomy Information

Taxonomy Code 1744P3200X
Grouping Other Service Providers
Classification Specialist
Specialization Prosthetics Case Management

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1194383398 Candice Williams Specialist 820 N Gloster St, Tupelo, MS 38804-1949 2019-06-03
1710505649 Lacrista Montgomery Specialist 811 Garfield St, Tupelo, MS 38801-5748 2020-07-07

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1932715216 Stacy Michelle Reed Specialist 121 Lonnie Jenkins Dr, Pearl, MS 39208-3520 2020-09-22
1962014100 Orthotic & Prosthetic Solutions LLC Specialist 3670 Lakeland Ln # B-4, Jackson, MS 39216-4700 2020-08-19
1598252645 Catiecha L Edwards Specialist 1162 Franklin St, Grenada, MS 38901-4237 2018-04-14
1992200950 Cristy M Mathews Specialist 132 Paulding Rd, Leakesville, MS 39451-3073 2018-03-29
1386146520 Jan A Jordan Specialist 1615 2nd Ave N, Columbus, MS 39701-4927 2018-03-04
1679085948 Alan Evans Specialist 106 North Lafayette St, Starkville, MS 39759 2017-10-26
1649725409 Tynita Steele Specialist 5304 Gautier Vancleave Rd, Gautier, MS 39553-4216 2016-08-22
1285097048 The Lauren Forte Hair Loss Replacement Center Specialist 143 Laura Lake Rd, Vicksburg, MS 39180-9787 2016-03-30
1073975066 Dermaine Antwan Johnson Specialist 3500 Highway 39 N Apt 77, Meridian, MS 39301-1339 2016-03-28
1710356936 Sophia Mcquarter Specialist 2706 Old Brandon Rd, Pearl, MS 39208-4701 2015-09-17
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Competitor

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City TUPELO
Zip Code 38801

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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