Individual
MR. ROBERT P SHACKELFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
113 AIRPORT ROAD, SUITE 200, SULPHUR SPRINGS, TX 75482
(903) 439-6302
(903) 439-2765
Mailing address
PO BOX 1367, SULPHUR SPRINGS, TX 75482
(903) 439-6302
(903) 439-2765
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G0922
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0053NG
BCBS
TX
05
—
033213202
—
TX
05
—
033213203
—
TX
01
—
4617433
AETNA
TX
Enumeration date
11/09/2006
Last updated
12/04/2012
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