Organization
JOE L SHACKELFORD OD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOE L. SHACKELFORD O.D. (MEMBER)
(251) 639-7101
Entity
Organization
Contact information
Practice address
685 SCHILLINGER RD S, MOBILE, AL 36695-8922
(251) 633-5011
(251) 633-5394
Mailing address
1840 BRADSHIRE DR, MOBILE, AL 36695-3078
(251) 639-7101
(251) 639-7101
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
S-421-TA-151
AL
Other
Enumeration date
05/06/2011
Last updated
06/22/2011
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