Provider Demographics
NPI:1932390523
Name:SHEPPARD, TOMMY D
Entity Type:Individual
Prefix:MR
First Name:TOMMY
Middle Name:D
Last Name:SHEPPARD
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 1:6755 QUAIL HOLLOW CT
Mailing Address - Street 2:APT 2
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-4522
Mailing Address - Country:US
Mailing Address - Phone:662-643-0471
Mailing Address - Fax:
Practice Address - Street 1:7410 MEMPHIS ARLINGTON RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38135-1908
Practice Address - Country:US
Practice Address - Phone:901-252-7869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor