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NPI Code Detail

MEDICARE: DR. KEVIN J SHANNON M.D.

MEDICARE: DR. KEVIN J SHANNON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RH0003XHematology & Oncology PhysicianD0053829MD

General Provider Information

NPI Number : 1881697894
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN J SHANNON M.D.
Provider Business Mailing Address
First Line : 1900 S MAIN ST
Second Line : MANAGED CARE DEPT
City : FINDLAY
State : OH
Zip : 45840-1214
Country : US
Telephone Number : 419-423-5262
Fax Number : 419-423-5550
Provider Business Practice Location Address
First Line : 15990 MEDICAL DR S
Second Line :
City : FINDLAY
State : OH
Zip : 45840-8894
Country : US
Telephone Number : 419-422-9898
Fax Number : 419-429-0805
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 04/18/2022

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