Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 18126 | NE |
N | 208600000X | Surgeon | 18126 | NE |
N | 208200000X | Surgeon | 425057 | KS |
N | 208600000X | Surgeon | 425057 | KS |
N | 208200000X | Surgeon | R2F07 | MO |
N | 208600000X | Surgeon | R2F07 | MO |
N | 2086X0206X | Surgical Oncologist | 425057 | KS |
Y | 2086X0206X | Surgical Oncologist | R2F07 | MO |
NPI | 1215976915 |
---|---|
Provider Name | John W Shook |
First Address | Kansas City, MO 64131 |
Second Address | Kansas City, MO 64111-5941 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 13/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1215976915 | (05) | MO |
E46375 | (02) | MO |