Provider Demographics
NPI:1780146076
Name:T.S.SHANKS, PLLC
Entity type:Organization
Organization Name:T.S.SHANKS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROLOGICAL SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHANKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-981-6210
Mailing Address - Street 1:716 S. FIRST STREET
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-5008
Mailing Address - Country:US
Mailing Address - Phone:731-885-9137
Mailing Address - Fax:731-885-8309
Practice Address - Street 1:1919 STATE ST STE 250
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-6805
Practice Address - Country:US
Practice Address - Phone:812-949-5933
Practice Address - Fax:812-949-5923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-04
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1154542181OtherNPI