# HOWARD L SHACKELFORD JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1750431094
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | 11190 | WV | — |
| 208600000X | Surgery Physician | 35042925 | OH | — |
| 2086S0127X | Trauma Surgery Physician | 11190 | WV | — |
| 2086S0127X | Trauma Surgery Physician | 35042925 | OH | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 11190 | WV | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 35042925 | OH | Yes |

## Other

- **Enumeration date:** 01/11/2007
- **Last updated:** 04/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0129426000 | — | WV |
| 05 | — | 0517748 | — | OH |