Individual
JOHN H SHACKELFORD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1421 ORLEANS RD, HARWICH, MA 02645-2148
(508) 778-4777
(508) 771-9555
Mailing address
297 NORTH ST, HYANNIS, MA 02601-5108
(508) 862-7777
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
220500
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2104296
—
MA
01
—
AA35717
HPHC
MA
01
—
J28724
BCBS
MA
Enumeration date
03/22/2006
Last updated
06/17/2019
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