| James Shackson Md | |
|
9525 Kenwood Rd Suite 16-382 Cincinnati OH 45242-6176 | |
| (513) 721-3504 | |
| (513) 345-6281 |
| Full Name | James Shackson Md |
|---|---|
| Speciality | Psychiatry & Neurology - Geriatric Psychiatry |
| Location | 9525 Kenwood Rd, Cincinnati, Ohio |
| Authorized Official Name and Position | James Shackson (PRESIDENT) |
| Authorized Official Contact | 5137213504 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James Shackson Md L 6122 Cincinnati OH 45270-6122 Ph: (513) 721-3504 | James Shackson Md 9525 Kenwood Rd Suite 16-382 Cincinnati OH 45242-6176 Ph: (513) 721-3504 |
| NPI Number | 1962565408 |
|---|---|
| Provider Enumeration Date | 12/18/2006 |
| Last Update Date | 06/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962565408 | NPI | - | NPPES |
| 934725 | Medicaid | OH | |
| P00381869 | Other | OH | MEDICARE RAILROAD |
| 200084400B | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | 35062208 (Ohio) | Primary |
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