| Doctor Name: | DR. JOHN SHEPPARD |
| NPI Number: | 1821148743 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | OS9316 |
| Business Practice Address: | 20 York St Tompkins 209 New Haven, CT - 065103220 |
| Business Phone Number: | 2036889503 |
| Business Fax Number: | |
| Mailing Address: | 105 Mckinley Ave, NEW HAVEN |
| State: | CT |
| Postal Code: | 065152733 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/11/2007 |
| NPI Last Update Date: | 09/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | OS9316 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |