Shockley, Kenneth F
Shockley, Kenneth F is an sole proprietor health care provider with primary practice located at 4047 Saladin Dr Se , Grand Rapids MI 49546-6249. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Shockley, Kenneth F can be contacted via phone (616) 956-9577.Contact Information
Primary practice address
4047 Saladin Dr Se
Grand Rapids MI 49546-6249
Phone: (616) 956-9577
Fax: (616) 956-5988
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 5101010606 | Michigan |
Profile Details
| NPI number | 1801854039 |
|---|---|
| LBN Legal business name | Shockley, Kenneth F |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 4th, 2006 |
| Last updated | Oct 17th, 2017 - 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 | 1801854039 | NPPES |
| Michigan | MEDICAID | 3153602 |
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