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Dr. Brian Edward Shockley, DPM
Podiatrist in Vicksburg, Mississippi
NPI 1477662229

Brian Edward Shockley is a Podiatrist based in Vicksburg, MS. Brian Edward Shockley practices in Vicksburg, MS and has the professional credentials of DPM. The NPI Number for Brian Edward Shockley is 1477662229 and holds a License No. MS80142 (Mississippi).

The current practice location address for Brian Edward Shockley is 1814 Mission 66, Vicksburg, MS and can be reached out via phone at 601-638-7520 and via fax at 601-638-7541.

Location: 1814 Mission 66, Vicksburg, MS, 39180-3710
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1477662229
Provider Name
Brian Edward Shockley
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
1814 Mission 66, Vicksburg, MS, 39180-3710
Phone Number
601-638-7520
Fax Number
601-638-7541
Provider Enumeration Date
08/29/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
5963224 01 LA AETNA
00119033 05 MS
1540447 05 LA
4800026580 01 LA RAILROAD MEDICARE
1851563 01 MS UNITED HEALTHCARE
4342670001 01 MS MEDICARE DME
5963224 01 MS AETNA
480026580 01 MS RAILROAD MEDICARE
1851563 01 LA UNITED HEALTHCARE
institution
Provider Business Practice Location Address Details
Address
1814 Mission 66
City
Vicksburg
State
Mississippi
Zip
39180-3710
Phone Number
601-638-7520
Fax Number
601-638-7541
person
Provider Business Mailing Address Details
Address
1814 Mission 66
City
Vicksburg
State
Mississippi
Zip
39180-3710
Phone Number
601-638-7520
Fax Number
601-638-7541
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
-
Taxonomy
213E00000X
License No.
MS80142 (Mississippi)
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
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