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General NPI Number Information
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NPI Number | 1205816014
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Entity Type | Individual
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Provider Name | ALBEN B. SHOCKLEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/18/2006
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 151 N GARDENMILE RD
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City | HENDERSON
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State | KY
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Zip | 42420-5543
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Country | US
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Telephone | 812-485-6030
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Fax | 812-485-6032
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Provider Business Mailing Address
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Address Line | 2211 MAYFAIR DR SUITE 101
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City | OWENSBORO
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State | KY
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Zip | 42301-4568
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Country | US
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Telephone | 270-688-1352
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Fax | 270-683-4313
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 26126
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01036897A
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License Number State | IN
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