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Contact Information

JAMES SHACKSON MD
9525 KENWOOD RD
SUITE 16-382
CINCINNATI, OH45242-6176
 Phone: 513-721-3504
 Fax: 513-345-6281
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for JAMES SHACKSON MD

NPI # 1962565408
LBN Legal business name JAMES SHACKSON MD
Authorized official JAMES SHACKSON - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/18/2006
Last updated 06/10/2008 - About 18 years ago
Identifiers
OH License # 35062208
IN Medicaid 200084400B
OH Medicaid 934725
OH Other P00381869 MEDICARE RAILROAD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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