Provider Demographics
NPI:1033437868
Name:MICHELLE A. SHELTON, MD, LLC
Entity Type:Organization
Organization Name:MICHELLE A. SHELTON, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-377-3475
Mailing Address - Street 1:5146 STAGE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-3139
Mailing Address - Country:US
Mailing Address - Phone:901-377-3475
Mailing Address - Fax:901-377-8068
Practice Address - Street 1:5146 STAGE RD STE 101
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-3139
Practice Address - Country:US
Practice Address - Phone:901-377-3475
Practice Address - Fax:901-377-8068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty