Shockley, Mark Edward

Shockley, Mark Edward is an individual health care provider with primary practice located at 3700 Washington Ave , Evansville IN 47714-0541. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Shockley, Mark Edward can be contacted via phone (812) 473-0181.

Contact Information

Primary practice address
3700 Washington Ave Evansville IN 47714-0541
Phone: (812) 473-0181
Fax: (812) 473-5822
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 01047527A Indiana

Profile Details

NPI number 1437140365
LBN Legal business name Shockley, Mark Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2005
Last updated May 26th, 2011 - about 13 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 1437140365 NPPES
Kentucky MEDICAID 64297914
Kentucky Other 000000501013
Kentucky Other 000000184048
Kentucky MEDICAID 200155630
Kentucky Other 000000193493

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