Provider Demographics
NPI:1366601593
Name:SHIFLETT, JAMES MASON (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MASON
Last Name:SHIFLETT
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 11407 DEPT 2130
Mailing Address - Street 2:UNIVERSITY PHYSICIANS
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-2130
Mailing Address - Country:US
Mailing Address - Phone:601-815-2005
Mailing Address - Fax:601-984-6439
Practice Address - Street 1:2500 NORTH STATE STREET
Practice Address - Street 2:DEPARTMENT OF NEUROSURGERY
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4500
Practice Address - Country:US
Practice Address - Phone:601-984-5700
Practice Address - Fax:601-984-6986
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2014-03-10
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MST-1637207T00000X
MS20664207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL156712Medicaid
LA295107Medicaid
MS00573859Medicaid
MS00573859Medicaid
MS302I147053Medicare PIN