Individual
JOHN ROBERT SHOCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2123 AUBURN AVE, SUITE 520, CINCINNATI, OH 45219-2906
(513) 585-1300
(513) 585-1358
Mailing address
2123 AUBURN AVE, SUITE 520, CINCINNATI, OH 45219-2906
(513) 585-1300
(513) 585-1358
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35069190S
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000569047
ANTHEM PIN
—
05
—
200153450
—
IN
05
—
2008777
—
OH
05
—
64954670
—
KY
01
—
P00685531
RAILROAD MEDICARE
—
Enumeration date
04/18/2006
Last updated
10/21/2020
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