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Edward Shackleford, DO
Emergency Medicine Physician in Kenosha, Wisconsin
NPI 1790769800

Edward Shackleford is a Emergency Medicine Physician based in Oak Brook, WI. Edward Shackleford practices in Kenosha, WI and has the professional credentials of DO. The NPI Number for Edward Shackleford is 1790769800 and holds a License No. 42953021 (Wisconsin).

The current practice location address for Edward Shackleford is 10400 75Th St, Kenosha, WI and can be reached out via phone at 262-697-7000 and via fax at 630-734-1560.

Location: 10400 75Th St, Kenosha, WI, 60522-3043
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1790769800
Provider Name
Edward Shackleford
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
10400 75Th St, Kenosha, WI, 60522-3043
Phone Number
262-697-7000
Fax Number
630-734-1560
Provider Enumeration Date
12/01/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
30099700 05 WI
institution
Provider Business Practice Location Address Details
Address
10400 75Th St
City
Kenosha
State
Wisconsin
Zip
53142-7884
Phone Number
262-697-7000
Fax Number
630-734-1560
person
Provider Business Mailing Address Details
Address
10400 75Th St
City
Kenosha
State
Wisconsin
Zip
53142-7884
Phone Number
262-697-7000
Fax Number
630-734-1560
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Emergency Medicine
Speciality
-
Taxonomy
207P00000X
License No.
42953021 (Wisconsin)
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
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