Individual
RAYMOND CALVIN SHACKELFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2350 MT PLEASANT RD, HERNANDO, MS 38632-1909
(662) 429-4448
(662) 429-5975
Mailing address
2350 MOUNT PLEASANT RD, HERNANDO, MS 38632-1909
(662) 429-4448
(662) 429-5975
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD589-94300
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00087049
—
MS
Enumeration date
03/01/2007
Last updated
05/05/2026
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