Provider Demographics
NPI:1922054881
Name:SHOCKEY, JAMES STEVEN (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:STEVEN
Last Name:SHOCKEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 E MAXWELL ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-2678
Mailing Address - Country:US
Mailing Address - Phone:859-253-0124
Mailing Address - Fax:859-231-8667
Practice Address - Street 1:125 E MAXWELL ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-2678
Practice Address - Country:US
Practice Address - Phone:859-253-0124
Practice Address - Fax:859-231-8667
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY22922174400000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64229222Medicaid
KYE01363Medicare UPIN
KY64229222Medicaid