Monnett, Shane Wylie

Monnett, Shane Wylie is an sole proprietor health care provider with primary practice located at 1001 Willow Creek Rd Ste 1200 , Prescott AZ 86301-1614. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Monnett, Shane Wylie can be contacted via phone (928) 458-2995.

Contact Information

Primary practice address
1001 Willow Creek Rd Ste 1200 Prescott AZ 86301-1614
Phone: (928) 458-2995
Fax: (928) 458-2139
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 009979 Arizona
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Surgery 208600000X 3410 West Virginia

Profile Details

NPI number 1760829378
LBN Legal business name Monnett, Shane Wylie
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 23rd, 2013
Last updated Mar 26th, 2024 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760829378 NPPES
Arizona Other 009979 AZ BOARD OF MEDICAL EXAMINERS
Arizona MEDICAID 189339 AZ BOARD OF MEDICAL EXAMINERS

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