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General NPI Number Information
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NPI Number | 1578541439
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Entity Type | Individual
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Provider Name | DAVID M SHACKELFORD MD
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Gender | Male
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Dates
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Enumeration Date | 01/02/2006
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 1224 TROTWOOD AVE
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City | COLUMBIA
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State | TN
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Zip | 38401-4802
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Country | US
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Telephone | 844-295-4871
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3239
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City | INDIANAPOLIS
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State | IN
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Zip | 46206-3239
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Country | US
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Telephone | 844-295-4871
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME176297
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 15386
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 20169
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 22806
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License Number State | ND
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