Individual
DR. JUSTIN R. SHIRLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5940 ULALI DR NE, KEIZER, OR 97303-1500
(270) 798-8254
Mailing address
5940 ULALI DR NE, KEIZER, OR 97303-1500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01073652A
IN
207Q00000X
Family Medicine Physician
Primary
MD217809
OR
207Q00000X
Family Medicine Physician
MD61478042
WA
Other
Enumeration date
07/16/2012
Last updated
10/13/2023
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