| Doctor Name: | DR. DELPHINE K. SHANNON |
| NPI Number: | 1609158260 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 18668 |
| Business Practice Address: | 12261 Highway 49 Suite 6 Gulfport, MS - 395032975 |
| Business Phone Number: | 2282060542 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1538, GULFPORT |
| State: | MS |
| Postal Code: | 395021538 |
| Phone Number: | 2285470736 |
| Fax Number: | 2288659265 |
| NPI Enumeration Date: | 09/09/2011 |
| NPI Last Update Date: | 09/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 18668 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |