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General NPI Number Information
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NPI Number | 1033426697
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Entity Type | Organization
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Legal Business Name | DAVID B. SHUCK DO, LLC
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Dates
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Enumeration Date | 09/02/2010
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Last Update Date | 09/02/2010
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Provider Practice Location Address
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Address Line | 14352 METCALF AVE
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City | OVERLAND PARK
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State | KS
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Zip | 66223-2987
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Country | US
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Telephone | 877-341-8075
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Fax |
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Provider Business Mailing Address
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Address Line | 14352 METCALF AVE
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City | OVERLAND PARK
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State | KS
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Zip | 66223-2987
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Country | US
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Telephone | 877-341-8075
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DAVID SHUCK
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Credential | D.O.
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Telephone | 877-341-8075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | O5-23677
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License Number State | KS
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