Individual
DAVID M SHACKELFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1224 TROTWOOD AVE, COLUMBIA, TN 38401-4802
(844) 295-4871
Mailing address
PO BOX 3239, INDIANAPOLIS, IN 46206-3239
(844) 295-4871
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
15386
TN
2085R0202X
Diagnostic Radiology Physician
20169
SC
2085R0202X
Diagnostic Radiology Physician
22806
ND
2085R0202X
Diagnostic Radiology Physician
ME176297
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300039095
RR MEDICARE
TN
05
—
3050164
—
TN
01
—
87131
BCBS
TN
Enumeration date
01/02/2006
Last updated
01/02/2026
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