Individual
MR. SHANNON E HULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
502 LOCUST ST, ALLISON, IA 50602
(319) 267-2759
(319) 267-2851
Mailing address
1001 MASON WAY, SHELL ROCK, IA 50670-1007
(319) 885-6530
(319) 885-6535
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001238
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9700100773
RR MEDICARE
IA
Enumeration date
01/04/2006
Last updated
05/30/2013
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