Provider Demographics
NPI:1356453021
Name:SHANKLIN, JOSEPG CARL (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPG
Middle Name:CARL
Last Name:SHANKLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2329 SUNSET POINT RD
Mailing Address - Street 2:STE 203
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-1438
Mailing Address - Country:US
Mailing Address - Phone:727-669-3911
Mailing Address - Fax:727-669-3813
Practice Address - Street 1:2329 SUNSET POINT RD
Practice Address - Street 2:STE 203
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-1438
Practice Address - Country:US
Practice Address - Phone:727-669-3911
Practice Address - Fax:727-669-3813
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00743122084P0800X, 2084P0804X
FLME743122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE3324ZMedicare ID - Type Unspecified
FLH07008Medicare UPIN