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Individual
DENTON SHANKS
Active
Individual
DENTON SHANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO MPH
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
05-39959
KS
207Q00000X
Family Medicine Physician
2016027615
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477991925
—
MO
01
—
P01703882
RR MEDICARE
MO
Enumeration date
06/03/2013
Last updated
02/27/2018
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