Individual
DR. SHANE WYLIE MONNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1001 WILLOW CREEK RD STE 1200, PRESCOTT, AZ 86301-1614
(928) 458-2995
(928) 458-2139
Mailing address
PO BOX 10880, PRESCOTT, AZ 86304-0880
(602) 406-4786
(916) 636-4358
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
009979
AZ
208600000X
Surgery Physician
3410
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009979
AZ BOARD OF MEDICAL EXAMINERS
AZ
05
—
189339
—
AZ
Enumeration date
05/23/2013
Last updated
08/14/2025
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