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1881915403

NPI Code Detail

MEDICARE: DR. JENNIFER GRIFFITH SHANKLIN M.D.

MEDICARE: DR. JENNIFER GRIFFITH SHANKLIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	MD-42793	IA
2	208600000X	Surgery Physician	66273	MN
3	208600000X	Surgery Physician	125.057738	IL
4	2086S0102X	Surgical Critical Care Physician	MD-42793	IA
5	2086S0127X	Trauma Surgery Physician	66273	MN
6	2086S0127X	Trauma Surgery Physician	MD-42793	IA
7	2086S0102X	Surgical Critical Care Physician	66273	MN

General Provider Information

NPI Number	:	1881915403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER GRIFFITH SHANKLIN M.D.

Provider Business Mailing Address
First Line	:	200 HAWKINS DR
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52242-1009
Country	:	US
Telephone Number	:	319-356-1616
Fax Number	:

Provider Business Practice Location Address
First Line	:	920 E 28TH ST STE 460
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1286
Country	:	US
Telephone Number	:	612-863-7770
Fax Number	:	612-863-7772

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2010
Last Update Date	:	11/26/2019

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Directions to “ DR. JENNIFER GRIFFITH SHANKLIN M.D.” Practice Location

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