Shockley, Mark S.
Shockley, Mark S. is an individual health care provider with primary practice located at 2710 Saint Francis Dr Suite 410, Waterloo IA 50702-5619. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Shockley, Mark S. can be contacted via phone (319) 272-5000.Contact Information
Primary practice address
2710 Saint Francis Dr Suite 410
Waterloo IA 50702-5619
Phone: (319) 272-5000
Fax: (319) 272-5264
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 34175 | Iowa |
Profile Details
| NPI number | 1831146042 |
|---|---|
| LBN Legal business name | Shockley, Mark S. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 31st, 2006 |
| Last updated | Jul 17th, 2007 - about 17 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 | 1831146042 | NPPES |
| Iowa | MEDICAID | 0249706 |
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