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Organization
JAMES SHACKSON MD
Active
Organization
JAMES SHACKSON MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES SHACKSON MD (PRESIDENT)
(513) 721-3504
Entity
Organization
Contact information
Practice address
9525 KENWOOD RD, SUITE 16-382, CINCINNATI, OH 45242-6176
(513) 721-3504
(513) 345-6281
Mailing address
L 6122, CINCINNATI, OH 45270-6122
(513) 721-3504
(513) 345-6281
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
35062208
OH
Other
Enumeration date
12/18/2006
Last updated
06/10/2008
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