Shettle, Philip Lee

Shettle, Philip Lee is an sole proprietor health care provider with primary practice located at 13113 66Th St , Largo FL 33773-1812. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Shettle, Philip Lee can be contacted via phone (727) 674-2500.

Contact Information

Primary practice address
13113 66Th St Largo FL 33773-1812
Phone: (727) 674-2500
Fax: (727) 674-2550
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 32591 Colorado
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 5101010879 Michigan
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X OS 6621 Florida

Profile Details

NPI number 1023016243
LBN Legal business name Shettle, Philip Lee
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 12th, 2005
Last updated Dec 16th, 2020 - about 4 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 1023016243 NPPES
Florida MEDICAID 378381200
Florida Other 180045006
Florida Other 80884

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