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Individual

MRS. LUCY KARA SHAMBLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
174 PINNELL ST STE D, RIPLEY, WV 25271-9105
(304) 372-1740
(304) 372-3069
Mailing address
174 PINNELL ST STE D, RIPLEY, WV 25271-9105
(304) 372-1740
(304) 372-3069

Taxonomy

Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
2473
WV
207Q00000X
Family Medicine Physician
Primary
2473
WV
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
003577627
UHC MPIN
WV
05
3810024964
WV
01
WV2080H
MEDICARE PTAN
WV
01
WV2180D
MEDICARE PTAN
WV
01
WV2180E
MEDICARE PTAN
WV
01
WV2180F
MEDICARE PTAN
WV
01
WV2180G
MEDICAARE PTAN
WV
Enumeration date
03/01/2009
Last updated
02/20/2024
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