Jeffrey B Shackelton
Dermatologist Dermatopathologist
640 W. Moana Lane
Reno
, Nevada 89509
Jeffrey B Shackelton
Dermatologist Dermatopathologist
640 W. Moana Lane
Reno
, Nevada 89509
(775) 283-4081
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About
Features
Specialties
- Dermatologist
- Dermatopathologist
Languages spoken
- English
Location
First Address
- Jeffrey B Shackelton
- 3950 G S Richards Blvd
- Carson City, NV
- Zip : 89703
- Fax : (775) 283-4081
- Phone : (775) 882-8777
Second Address
- Jeffrey B Shackelton
- 640 W. Moana Lane
- Reno, NV
- Zip : 89509
- Fax : (775) 323-6814
- Phone : (775) 324-0699
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207N00000X | Dermatologist | 14618 | NV |
| N | 207ND0900X | Dermatopathologist | MD185082 | OR |
National Provider Identifier
| NPI | 1699902726 |
|---|---|
| Provider Name | Jeffrey B Shackelton |
| First Address | Carson City, NV 89703 |
| Second Address | Reno, NV 89509 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/06/2009 |
| Last Update Date | 09/11/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.