Shetlar, John M
Shetlar, John M is an individual health care provider with primary practice located at 1100 N 4Th St , Leavenworth KS 66048-1572. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Shetlar, John M can be contacted via phone (888) 381-4858.Contact Information
Primary practice address
1100 N 4Th St
Leavenworth KS 66048-1572
Phone: (888) 381-4858
Fax: (913) 297-9628
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 0524233 | Kansas |
Profile Details
| NPI number | 1821053091 |
|---|---|
| LBN Legal business name | Shetlar, John M |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 19th, 2006 |
| Last updated | Dec 26th, 2023 - about last year |
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 | 1821053091 | NPPES |
| Kansas | MEDICAID | 100162320E |
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