Shackelford, David M

Shackelford, David M is an individual health care provider with primary practice located at 1224 Trotwood Ave , Columbia TN 38401-4802. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Shackelford, David M can be contacted via phone (844) 295-4871.

Contact Information

Primary practice address
1224 Trotwood Ave Columbia TN 38401-4802
Phone: (844) 295-4871
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 20169 South Carolina
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 15386 Tennessee

Profile Details

NPI number 1578541439
LBN Legal business name Shackelford, David M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 2nd, 2006
Last updated Aug 4th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578541439 NPPES
Tennessee Other 87131 BCBS
Tennessee Other 300039095 BCBS
Tennessee MEDICAID 3050164 BCBS

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