Gary Y Shaw, MD | |
180 S Main St, Canton, IL 61520-2608 | |
(309) 647-0201 | |
(309) 649-6880 |
Full Name | Gary Y Shaw |
---|---|
Gender | Male |
Speciality | Otolaryngology |
Experience | 41 Years |
Location | 180 S Main St, Canton, Illinois |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1912940958 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207YX0905X | Otolaryngology - Otolaryngology/facial Plastic Surgery | 109774 (Missouri) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Graham Hospital Association | Canton, IL | Hospital |
Mason District Hospital | Havana, IL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Graham Hospital Association | 2769375021 | 90 |
Mason Hospital District | 2466360607 | 30 |
Entity Name | Mason Hospital District |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1902849649 PECOS PAC ID: 2466360607 Enrollment ID: O20040412000399 |
Entity Name | Graham Hospital Association |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1780692087 PECOS PAC ID: 2769375021 Enrollment ID: O20040510000873 |
Entity Name | Knox Clinic Corp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1265481006 PECOS PAC ID: 6305813411 Enrollment ID: O20040916000542 |
Mailing Address | Practice Location Address |
---|---|
Gary Y Shaw, MD 180 S Main St, Canton, IL 61520-2608 Ph: (309) 647-0201 | Gary Y Shaw, MD 180 S Main St, Canton, IL 61520-2608 Ph: (309) 647-0201 |
Fordyce Edward Stivers, MD Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 175 S Main St, Canton, IL 61520 Phone: 309-647-0201 Fax: 309-649-5302 |