Provider Demographics
NPI:1851308480
Name:HELMHOUT, SHAUN LAUGHLIN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAUN
Middle Name:LAUGHLIN
Last Name:HELMHOUT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARY
Other - Middle Name:SHAUN
Other - Last Name:HELMHOUT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1397 BELK BLVD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-5301
Mailing Address - Country:US
Mailing Address - Phone:662-236-4675
Mailing Address - Fax:662-281-0819
Practice Address - Street 1:1397 BELK BLVD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5301
Practice Address - Country:US
Practice Address - Phone:662-236-4675
Practice Address - Fax:662-281-0819
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS17224207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSP00463815OtherRAILROAD MEDICARE
MS01934351Medicaid
MS080004115Medicare ID - Type UnspecifiedSECOND LOC
MS080262895Medicare ID - Type UnspecifiedMEDICARE HERNANDO
MS080004344Medicare ID - Type UnspecifiedHEALTH 1ST MEDICARE #
MSP00463815OtherRAILROAD MEDICARE
MS01934351Medicaid
MS302I083545Medicare PIN
080003471Medicare ID - Type Unspecified
MSC03306Medicare ID - Type UnspecifiedHEALTH 1ST CAHABA GRP #