Provider Demographics
NPI:1750473427
Name:SHEPPARD, JOSEPH A (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:SHEPPARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3878 MCMANN RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-2347
Mailing Address - Country:US
Mailing Address - Phone:513-753-5437
Mailing Address - Fax:513-753-7517
Practice Address - Street 1:3878 MCMANN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-2347
Practice Address - Country:US
Practice Address - Phone:513-753-5437
Practice Address - Fax:513-753-7517
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1821111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0204906Medicaid
OH0204906Medicaid
OHSH0711162Medicare ID - Type Unspecified