| William H Shackelford Md | |
|
525 N Vine St Arthur IL 61911-1137 | |
| (217) 543-3628 | |
| (217) 543-2921 |
| Full Name | William H Shackelford Md |
|---|---|
| Speciality | Family Medicine |
| Location | 525 N Vine St, Arthur, Illinois |
| Authorized Official Name and Position | William H Shackelford (OWNER) |
| Authorized Official Contact | 2175433628 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| William H Shackelford Md 525 N Vine St Arthur IL 61911-1137 Ph: (217) 543-3628 | William H Shackelford Md 525 N Vine St Arthur IL 61911-1137 Ph: (217) 543-3628 |
| NPI Number | 1164418067 |
|---|---|
| Provider Enumeration Date | 09/26/2005 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164418067 | NPI | - | NPPES |
| 0007415015 | Other | IL | BLUE SHIELD |
| 036034153-1 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |