Dr Brian Edward Shockley, D P M is a medicare enrolled "Podiatrist" provider in Vicksburg, Mississippi. His current practice location is
1814 Mission 66, Vicksburg, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(601) 638-7520.
Dr Brian Edward Shockley is licensed to practice in Mississippi (license number MS80142) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1477662229.
Healthcare Provider's Profile
| Full Name | Dr Brian Edward Shockley |
|---|
| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 1814 Mission 66, Vicksburg, Mississippi |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Brian Edward Shockley attended and graduated from in
NPI Data:
- NPI Number: 1477662229
- Provider Enumeration Date: 08/29/2006
- Last Update Date: 01/26/2011
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Dr Brian Edward Shockley such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1477662229 | NPI | - | NPPES |
| 5963224 | Other | LA | AETNA |
| 00119033 | Medicaid | MS | |
| 1540447 | Medicaid | LA | |
| 4800026580 | Other | LA | RAILROAD MEDICARE |
| 1851563 | Other | MS | UNITED HEALTHCARE |
| 4342670001 | Other | MS | MEDICARE DME |
| 5963224 | Other | MS | AETNA |
| 480026580 | Other | MS | RAILROAD MEDICARE |
| 1851563 | Other | LA | UNITED HEALTHCARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 213E00000X | Podiatrist | MS80142 (Mississippi) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Brian Edward Shockley is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Brian Edward Shockley, D P M
1814 Mission 66,
Vicksburg, MS 39180-3710
Ph: (601) 638-7520 | Dr Brian Edward Shockley, D P M
1814 Mission 66,
Vicksburg, MS 39180-3710
Ph: (601) 638-7520 |
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