| Shavetta D Conner, MD | |
|
295 Summar Ave, Jackson, TN 38301 | |
| (731) 421-6703 | |
| (731) 935-7093 |
| Full Name | Shavetta D Conner |
|---|---|
| Gender | Female |
| Speciality | Infectious Disease |
| Experience | 34 Years |
| Location | 295 Summar Ave, Jackson, Tennessee |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235283623 | NPI | - | NPPES |
| 3897153 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2083P0901X | Preventive Medicine - Public Health & General Preventive Medicine | 0000024830 (Tennessee) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| State Of Tennessee | 5698687077 | 18 |
| Entity Name | State Of Tennessee |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487791315 PECOS PAC ID: 5698687077 Enrollment ID: O20031104000309 |
| Mailing Address | Practice Location Address |
|---|---|
| Shavetta D Conner, MD 295 Summar Ave, Jackson, TN 38301 Ph: (731) 421-6703 | Shavetta D Conner, MD 295 Summar Ave, Jackson, TN 38301 Ph: (731) 421-6703 |
Kelvin Wren, MD Preventive Medicine Medicare: Not Enrolled in Medicare Practice Location: 174 Murray Guard Dr, Suite D, Jackson, TN 38305 Phone: 731-660-4916 Fax: 731-660-6759 | |
Karen K Codjoe, MD Preventive Medicine Medicare: Not Enrolled in Medicare Practice Location: 295 Summar Ave, Jackson, TN 38301 Phone: 731-421-6782 Fax: 731-935-7093 | |
Mrs. Charlotte Deniece Coleman, MD Preventive Medicine Medicare: Not Enrolled in Medicare Practice Location: 295 Summar Avenue, West Tennesse Regional Office, Jackson, TN 38301 Phone: 731-423-6600 Fax: 731-935-7093 |