Individual
JEFFREY B SHACKELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
640 W. MOANA LANE, RENO, NV 89509
(775) 324-0699
(775) 323-6814
Mailing address
3950 G S RICHARDS BLVD, CARSON CITY, NV 89703
(775) 882-8777
(775) 283-4081
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
14618
NV
207ND0900X
Dermatopathology Physician
MD185082
OR
Other
Enumeration date
06/16/2009
Last updated
11/09/2021
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