DR. Shane M Tackitt, DO

NPI #1588035976 in Mansfield, Texas

Provider Information

NPI Number: 1588035976
Entity Type: Individual
Name: DR. Shane M Tackitt, DO
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Internal Medicine
Credential: DO
Enumeration Date: Oct 12, 2015
Last Updated: Jul 1, 2020

Practice Location

Address: 2700 E BROAD ST
City: Mansfield
State: Texas
ZIP Code: 76063-5899
Phone: (682) 242-6470

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Hospitalist	208M00000X
Student in an Organized Health Care Education/Training Program	390200000X
Internal Medicine	207R00000X	Primary

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