Provider Demographics
NPI:1245203355
Name:WALTON-SHIRLEY, MELISSA K (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:K
Last Name:WALTON-SHIRLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 GREAT CIRCLE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1317
Mailing Address - Country:US
Mailing Address - Phone:615-451-9200
Mailing Address - Fax:615-230-9120
Practice Address - Street 1:300 STEAM PLANT RD
Practice Address - Street 2:SUITE 300
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3032
Practice Address - Country:US
Practice Address - Phone:615-451-9200
Practice Address - Fax:615-230-9120
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY25180207RC0000X
TN53275207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ013731Medicaid
KY60014103OtherRAILROAD MEDICARE
KY000000048055OtherANTHEM BC/BS
KY64251804Medicaid
TN6048728OtherBLUE CROSS/BLUE SHIELD
TNP01564018OtherRR MEDICARE
KY64251804Medicaid
KY000000048055OtherANTHEM BC/BS
KY60014103OtherRAILROAD MEDICARE