Shaffer, Kenton L

Shaffer, Kenton L is an individual health care provider with primary practice located at 211 West 33Rd Street , Kearney NE 68845. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Shaffer, Kenton L can be contacted via phone (308) 865-2141.

Contact Information

Primary practice address
211 West 33Rd Street Kearney NE 68845
Fax: (308) 234-7582
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 12336 Nebraska

Profile Details

NPI number 1558445320
LBN Legal business name Shaffer, Kenton L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2006
Last updated Jul 8th, 2007 - about 19 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 1558445320 NPPES
Other 07365 BCBS
MEDICAID 47064194537 BCBS

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