Individual
TODD STILES SHANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
01068505A
IN
207T00000X
Neurological Surgery Physician
40612
KY
207T00000X
Neurological Surgery Physician
Primary
S9413
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200952360
—
IN
05
—
7100075340
—
KY
Enumeration date
05/01/2007
Last updated
12/13/2024
Update your record
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