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General NPI Number Information
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NPI Number | 1831141290
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Entity Type | Individual
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Provider Name | JOHN R SHANK M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 04/18/2013
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Provider Practice Location Address
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Address Line | 2446 RESEARCH PKWY SUITE 200
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-1087
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Country | US
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Telephone | 719-623-1050
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Fax | 719-623-1052
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Provider Business Mailing Address
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Address Line | 2446 RESEARCH PKWY SUITE 200
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-1087
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Country | US
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Telephone | 719-623-1050
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Fax | 719-623-1052
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | CO40999
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | CO40999
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number | CO40999
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License Number State | CO
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