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Contact Information

JONATHAN P SHEPHERD, MD
263 FARMINGTON AVE
FARMINGTON, CT06030-8036
 Phone: 860-679-4100
 Fax: 860-679-1064
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Urogynecology and Reconstructive Pelvic Surgery

207VF0040X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for JONATHAN P SHEPHERD · (Male)

NPI # 1114048329
Status Active
Credentials MD
Entity Individual
Enumeration date 04/03/2007
Last updated 07/28/2025 - About 10 months ago
Sole proprietor 1 No
Identifiers
  • CT License # 55313
  • MA License # 269626
  • MA Medicaid 110128968A
Hospital affiliation(s)
  • HARTFORD HOSPITAL - (Acute Care)
    80 SEYMOUR STREET
    HARTFORD, CT 06102
  • JOHN DEMPSEY HOSPITAL - (Acute Care)
    263 FARMINGTON AVE
    FARMINGTON, CT 06032
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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