Provider Demographics
NPI:1689132078
Name:SHEPHERD, ANTHONY FRANK LOUIS (PA-C)
Entity Type:Individual
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First Name:ANTHONY FRANK
Middle Name:LOUIS
Last Name:SHEPHERD
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:2704 YOUNGBLOOD ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5534
Mailing Address - Country:US
Mailing Address - Phone:530-249-7934
Mailing Address - Fax:
Practice Address - Street 1:920 CHURCH ST N
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2927
Practice Address - Country:US
Practice Address - Phone:704-403-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-05
Last Update Date:2023-10-12
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer