Individual
GARRETT SHACKLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2515 GRAND PRAIRIE PKWY, WAUKEE, IA 50263-8979
(515) 265-1300
Mailing address
2515 GRAND PRAIRIE PKWY, WAUKEE, IA 50263-8979
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
125.068578
IL
208600000X
Surgery Physician
MD-56398
IA
208C00000X
Colon & Rectal Surgery Physician
Primary
DR.0069230
CO
208C00000X
Colon & Rectal Surgery Physician
Primary
MD-56398
IA
Other
Enumeration date
06/01/2016
Last updated
02/03/2026
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