EDWARD SHACKLEFORD, DO

Emergency Medicine

Active Individual
NPI: 1790769800

Practice Address

10400 75TH ST
AURORA MEDICAL CENTER
Kenosha, WI 53142

Phone: (262) 697-7000

Specialties

Specialty Code Primary License
Emergency Medicine 207P00000X Yes 42953021 (WI)

Frequently Asked Questions

NPI 1790769800 is the National Provider Identifier for EDWARD SHACKLEFORD, DO, a Emergency Medicine provider located in Kenosha, WI. This NPI was enumerated on December 1, 2005.
EDWARD SHACKLEFORD, DO practices at 10400 75TH ST, AURORA MEDICAL CENTER, Kenosha, WI 53142.

Quick Facts

NPI
1790769800
Type
Individual
Enumerated
Dec 1, 2005
Last Updated
Jul 8, 2007

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