Provider Demographics
NPI:1881085991
Name:THORPE, SHAWN
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:THORPE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 TOUCHTON RD E
Mailing Address - Street 2:BLDG. 100 STE. 150
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-8299
Mailing Address - Country:US
Mailing Address - Phone:904-647-1555
Mailing Address - Fax:877-583-2928
Practice Address - Street 1:4600 TOUCHTON RD E
Practice Address - Street 2:BLDG. 100 STE. 150
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-8299
Practice Address - Country:US
Practice Address - Phone:904-647-1555
Practice Address - Fax:877-583-2928
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator