Organization
RYAN SHACKELFORD MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES RYAN SHACKELFORD MD (PSYCHIATRIST)
(208) 297-3698
Entity
Organization
Contact information
Practice address
1525 S OWYHEE ST, BOISE, ID 83705-6014
(208) 297-3698
(208) 561-8051
Mailing address
1525 S OWYHEE ST, BOISE, ID 83705-6014
(208) 297-3698
(208) 561-8051
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
11/17/2022
Last updated
11/17/2022
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