Mr Jerry Lee Shaw, PT is a
Specialist/technologist - Athletic Trainer based in Opelika, Alabama. Mr Jerry Lee Shaw is licensed to practice in Alabama (license number 96096) and his current practice location is
2000 Pepperell Pkwy, Opelika, Alabama. He can be reached at his office (for appointments etc.) via phone at
(334) 528-3270.
NPI number for Mr Jerry Lee Shaw is 1336186717 and his current mailing address is 1030 Gregory Glen Rd, Opelika, Alabama. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1336186717.
Healthcare Provider's Profile
Full Name | Mr Jerry Lee Shaw |
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Gender | Male |
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Speciality | Specialist/technologist - Athletic Trainer |
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Location | 2000 Pepperell Pkwy, Opelika, Alabama |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1336186717
- Provider Enumeration Date: 06/02/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mr Jerry Lee Shaw such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1336186717 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225100000X | Physical Therapist | PTH2028 (Alabama) | Primary |
2255A2300X | Specialist/technologist - Athletic Trainer | 96096 (Alabama) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jerry Lee Shaw is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Jerry Lee Shaw, PT 1030 Gregory Glen Rd, Opelika, AL 36801-9417 Ph: (334) 826-3353 | Mr Jerry Lee Shaw, PT 2000 Pepperell Pkwy, Opelika, AL 36801-5452 Ph: (334) 528-3270 |
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