Individual
SHANE KEITH BACKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
838 MARKET STREET, ZANESVILLE, OH 43701
(740) 452-9319
(740) 452-2427
Mailing address
13333 NORTHWEST FWY, STE 540, HOUSTON, TX 77040-6166
(740) 452-9319
(740) 452-2427
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35082724
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2409870
—
OH
Enumeration date
02/08/2006
Last updated
06/02/2022
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