Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Tyler Reshadrich-Shaurice Shack, MD

Individual provider Anesthesiology Physician · NPI 1386105815

Tyler Reshadrich-Shaurice Shack, MD is an Anesthesiology in Jackson, Mississippi. Graduated from University of Mississippi School of Medicine in 2019, 7 years ago. Practices with State of Mississippi - University of Mississippi Medical Center, a 952-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
7
Trained at
University of Mississippi School of Medicine
Licensed in
MS
In the registry since
2019
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2500 N State St
Jackson, MS 39216-4500
Phone: (601) 984-5914
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 33326 (MS)

Record details

NPI number1386105815
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 27, 2019
Last updated in NPPESAugust 8, 2025
Certification dateAugust 8, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolUNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Graduated 2019 (7 years in practice)
Group practice State Of Mississippi - University Of Mississippi Medical Center — 952 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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