DR. MICHAEL MCSHAN (NPI# 1912082249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912082249 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL MCSHAN |
| Credential | MD |
| Practice Address |
1711 S Henderson Blvd Suite 100 Kilgore TX 75662-3563 |
| Mailing Address |
Po Box 731218 Dallas TX 75373-1218 |
| Practice Telephone | 9033153800 |
| Practice Fax Number | 9039845367 |
| Mailing Telephone | 9033153800 |
| Mailing Fax Number | 9039845367 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2014-11-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | E4519 | TX | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | E4519 | TX | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | E4519 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 130926203 | 05 | |
| TX | BLUE CROSS BLUE SHIELD | 00BP62 | 01 |
| TX | TAX ID | 752883733 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518389626 | Michael Mumme Mcshan Jr. | Counselor | 900 Wilkinson St, Mandeville, LA 70448-3533 | 2014-01-08 |
| Street Address |
1711 S HENDERSON BLVD SUITE 100 |
| City | KILGORE |
| State | TX |
| Zip Code | 75662-3563 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669458436 | Longhorn Drug Company | Pharmacy | 1711 S Henderson Blvd, Kilgore, TX 75662-3563 | 2005-12-22 |
| 1033481106 | Michael W. Mcshan, M.d., P.a. | Family Medicine | 1711 S Henderson Blvd, Suite 300, Kilgore, TX 75662-3563 | 2012-02-03 |
| 1073648028 | Longhorn Drug Company | Durable Medical Equipment & Medical Supplies | 1711 S Henderson Blvd, #100, Kilgore, TX 75662-3563 | 2007-02-22 |
| 1568495448 | Mark L Dillingham | Physician Assistant | 1711 S Henderson Blvd, Suite 100, Kilgore, TX 75662-3563 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346890621 | Linda Gail Watson | Technician | 190 Glendale St, Kilgore, TX 75662 | 2019-09-18 |
| 1174185151 | Jennifer Darlene Franks | Registered Nurse | 6144 Gateway Center Pmb # 320, Kilgore, TX 75662 | 2019-07-01 |
| 1215363312 | Kilgore Integrated Health Pllc | Chiropractor | 726 Us Highway 259 N, Kilgore, TX 75662 | 2013-09-20 |
| 1407172240 | Jeffrey Alan Davis | Specialist/Technologist | 300 N. Kilgore Street, Kilgore, TX 75662 | 2010-04-19 |
| 1396923777 | Rachel Thunder Rose Wyatt | Physical Therapist | 1200 Dudley Road, Kilgore, TX 75662 | 2008-02-07 |
| 1346313673 | Brookshire Grocery Company | Pharmacy | 747 Hwy 259 North, Attention Pharmacy Dept, Kilgore, TX 75662 | 2006-11-16 |
| 1417026451 | Jeffery John Pinkerton | Optometrist | 800 Highway 259 North, Kilgore, TX 75662 | 2006-11-06 |
| 1831205004 | Joseph Claude De Graffenried Jr. | Dentist | 238 Lawrence St, Kilgore, TX 75662 | 2006-08-21 |
| 1235159500 | Charles Robert Cottier | Chiropractor | 316 Henderson, Kilgome, TX 75662 | 2006-07-20 |
| 1346509494 | Kelton Hospice, Inc. | Hospice Care, Community Based | 1100 Stone Road, Suite 269, Kilgore, TX 75662 | 2012-05-10 |
| Find all providers in zip 75662 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.