Shackleford, Donald E

Shackleford, Donald E is an individual health care provider with primary practice located at 1061 Harmon Ave , Fort Stewart GA 31314. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Shackleford, Donald E can be contacted via phone (912) 435-6965.

Contact Information

Primary practice address
1061 Harmon Ave Fort Stewart GA 31314
Phone: (912) 435-6965
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 01068929A Indiana

Profile Details

NPI number 1871596486
LBN Legal business name Shackleford, Donald E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2005
Last updated Jun 11th, 2018 - about 7 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 1871596486 NPPES
Indiana MEDICAID 201003930
Indiana Other 192890008
Indiana MEDICAID 64271570

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