Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
EDWARD SHACKLEFORD, DO
ActiveEDWARD SHACKLEFORD, DO is a Emergency Medicine healthcare provider located in KENOSHA, Wisconsin. NPI 1790769800 is currently active in the NPPES registry. Verify at CMS.
Emergency Medicine · KENOSHA, WI
Registration Details
- NPI Number
- 1790769800
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 1, 2005 (20.735017407915 yrs)
- Last Updated
- Jul 8, 2007
- License
-
42953021 (WI)
Practice Information
- Address
-
10400 75TH STAURORA MEDICAL CENTERKENOSHA, WI, 531427884Browse WI providers · Browse ZIP 53142
- Phone
- 2626977000
- Fax
- 6307341560
- Primary Specialty
-
Emergency Medicine
207P00000X
Other Emergency Medicine Providers in KENOSHA, WI
| Name | Credential | NPI |
|---|---|---|
| EMMIE ANDREA CHEN | M.D. | 1699764068 |
| MICHAEL PETER JONES | M.D. | 1477543544 |
| DR. ROMMEL ORTIZ BOTE' | M.D. | 1841280948 |
| DR. THOMAS J. KIRAGES | M.D. | 1346231396 |
| MARC CRESCENZO | MD | 1881678993 |
| DAVID ERIC FARKAS | MD | 1043294101 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.