Antle, Shawn Douglas
Antle, Shawn Douglas is an individual health care provider with primary practice located at Beloit Memorial Hospital 1969 W. Hart Road, Beloit WI 53511-2230. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Antle, Shawn Douglas can be contacted via phone (608) 363-5971.Contact Information
Primary practice address
Beloit Memorial Hospital 1969 W. Hart Road
Beloit WI 53511-2230
Phone: (608) 363-5971
Fax: (608) 363-5737
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | 46666020 | Wisconsin |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 46666-20 | Wisconsin |
Profile Details
| NPI number | 1336163922 |
|---|---|
| LBN Legal business name | Antle, Shawn Douglas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 27th, 2006 |
| Last updated | Feb 28th, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336163922 | NPPES |
| Wisconsin | MEDICAID | 1336163922 | |
| Wisconsin | MEDICAID | 34513100 |
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