EDWARD SHACKLEFORD

KENOSHA, WI
NPI1790769800
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: WI  42953021)
Enumeration Date2005-12-01
Last Update Date2007-07-08
Business Address
-- EDWARD SHACKLEFORD DO
10400 75TH ST AURORA MEDICAL CENTER
KENOSHA, WI 53142-7884
Phone number: 262-697-7000
Mailing Address
-- EDWARD SHACKLEFORD DO
PO BOX 3043 MEA AEA KENOSH SC
OAK BROOK, IL 60522-3043
Phone number: 630-734-0200
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