Shackelford, John H
Shackelford, John H is an individual health care provider with primary practice located at 1421 Orleans Rd , Harwich MA 02645-2148. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Shackelford, John H can be contacted via phone (508) 778-4777.Contact Information
Primary practice address
1421 Orleans Rd
Harwich MA 02645-2148
Phone: (508) 778-4777
Fax: (508) 771-9555
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 220500 | Massachusetts |
Profile Details
| NPI number | 1598724072 |
|---|---|
| LBN Legal business name | Shackelford, John H |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 22nd, 2006 |
| Last updated | Jun 17th, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598724072 | NPPES |
| Massachusetts | MEDICAID | 2104296 | |
| Massachusetts | Other | J28724 | |
| Massachusetts | Other | AA35717 |
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