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Individual

HOWARD L SHACKELFORD JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
46150 NATIONAL RD W, SAINT CLAIRSVILLE, OH 43950-8715
(740) 695-2443
(304) 233-6073
Mailing address
PO BOX 6824, WHEELING, WV 26003-0921
(304) 233-2455
(304) 233-6073

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
11190
WV
208600000X
Surgery Physician
35042925
OH
2086S0127X
Trauma Surgery Physician
11190
WV
2086S0127X
Trauma Surgery Physician
35042925
OH
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
11190
WV
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
35042925
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0129426000
WV
05
0517748
OH
Enumeration date
01/11/2007
Last updated
04/21/2022
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