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Individual

DR. CORNELIUS J SHANEYFELT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
12 N JEFFERSON ST, KNIGHTSTOWN, IN 46148-1243
(765) 345-5405
(765) 345-5405
Mailing address
PO BOX 25, KNIGHTSTOWN, IN 46148-0025
(765) 345-5405
(765) 345-5405

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001864B
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100183230A
IN
Enumeration date
01/23/2007
Last updated
11/11/2008
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