| Ryan Shackelford Md, Pllc | |
|
1525 S Owyhee St Boise ID 83705-6014 | |
| (208) 297-3698 | |
| (208) 561-8051 |
| Full Name | Ryan Shackelford Md, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1525 S Owyhee St, Boise, Idaho |
| Authorized Official Name and Position | James Ryan Shackelford (PSYCHIATRIST) |
| Authorized Official Contact | 2082973698 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ryan Shackelford Md, Pllc 1525 S Owyhee St Boise ID 83705-6014 Ph: (208) 297-3698 | Ryan Shackelford Md, Pllc 1525 S Owyhee St Boise ID 83705-6014 Ph: (208) 297-3698 |
| NPI Number | 1447969506 |
|---|---|
| Provider Enumeration Date | 11/17/2022 |
| Last Update Date | 11/17/2022 |
| Certification Date | 11/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447969506 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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