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General NPI Number Information
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NPI Number | 1033220280
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Entity Type | Individual
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Provider Name | WILLIAM DOUGLAS SHAVER DMD
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 2816 VEACH ROAD
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City | OWENSBORO
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State | KY
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Zip | 42303-6295
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Country | US
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Telephone | 270-926-6100
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Fax | 270-926-6195
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Provider Business Mailing Address
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Address Line | 2816 VEACH ROAD
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City | OWENSBORO
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State | KY
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Zip | 42303-6295
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Country | US
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Telephone | 270-926-6100
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Fax | 270-926-6195
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4637
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 4637
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License Number State | KY
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