Charlotte L Shackelford (NPI# 1366601015, PAC ID# 4880726256) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1366601015 |
| PAC ID by PECOS | 4880726256 |
| Professional Enrollment ID | I20100720001038 |
| Full Name | Charlotte L Shackelford |
| Organization Legal Name | PURCELL FAMILY PRACTICE INC |
| Address |
1401 N 4th St Suite 107 Purcell OK 73080-1806 |
| Phone Number | 4055275400 |
| Gender | F |
| Graduation Year | 1995 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 3678674934 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 370158 | PURCELL MUNICIPAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1401 N 4th St, Suite 107, Purcell, OK 73080-1806 | 4055275400 | PURCELL FAMILY PRACTICE INC |
| 1500 N Green Ave, Purcell, OK 73080-1642 | PURCELL MUNICIPAL HOSPITAL |
| Organization Legal Name | PURCELL FAMILY PRACTICE INC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Timara L Stelling | Physician Assistant | Purcell Family Practice Inc | 1401 N 4th St, Suite 107, Purcell, OK 73080-1806 |
| David B Dye | Family Medicine | Purcell Family Practice Inc | 1401 N 4th St, Suite 107, Purcell, OK 73080-1806 |
| Street Address |
1401 N 4TH ST SUITE 107 |
| City | PURCELL |
| State | OK |
| Zip | 73080-1806 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Timara L Stelling | Physician Assistant | Purcell Family Practice Inc | 1401 N 4th St, Suite 107, Purcell, OK 73080-1806 |
| David B Dye | Family Medicine | Purcell Family Practice Inc | 1401 N 4th St, Suite 107, Purcell, OK 73080-1806 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Alina Justiz | Anesthesiology | Oklahoma Pain Physicians PC | 1500 N Green Ave, Purcell, OK 73080-1642 |
| Andrew S White | Emergency Medicine | Mcclain Emergency Group, LLC | 1500 N Green Ave, Purcell, OK 73080-1642 |
| Amy Alane Mikles | Physician Assistant | Purcell Municipal Hospital | 1500 N Green Ave, Purcell, OK 73080-1642 |
| Phong Q Luu | Family Medicine | Mcclain Emergency Group, LLC | 1500 N Green Ave, Purcell, OK 73080-1642 |
| Julie B Utley | Physician Assistant | Purcell Municipal Hospital | 1500 N Green Ave, Purcell, OK 73080-1642 |
| Scott A Chappell | Emergency Medicine | Mcclain Emergency Group, LLC | 1500 N Green Ave, Purcell, OK 73080-1642 |
| Tonja S Shandy | Physician Assistant | Purcell Municipal Hospital | 1500 N Green Ave, Purcell, OK 73080-1642 |
| Cori E Wadley | Physician Assistant | Purcell Municipal Hospital | 1500 N Green Ave, Purcell, OK 73080-1642 |
| Tyler Adams | Emergency Medicine | Mcclain Emergency Group, LLC | 1500 N Green Ave, Purcell, OK 73080-1642 |
| Cody J Rice | Emergency Medicine | Mcclain Emergency Group, LLC | 1500 N Green Ave, Purcell, OK 73080-1642 |
| Find all physicians in zip 73080 | |||
| City | PURCELL |
| Zip Code | 73080 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | PURCELL + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Charlotte L Shackelford.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.