Provider Demographics
NPI:1407294630
Name:SHELBY, LYNDLE DUANE (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNDLE
Middle Name:DUANE
Last Name:SHELBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:421 W BROADWAY STE 200
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-9046
Mailing Address - Country:US
Mailing Address - Phone:712-322-6000
Mailing Address - Fax:712-322-6200
Practice Address - Street 1:1101 9TH ST SE
Practice Address - Street 2:
Practice Address - City:SIOUX CENTER
Practice Address - State:IA
Practice Address - Zip Code:51250-2501
Practice Address - Country:US
Practice Address - Phone:712-722-2609
Practice Address - Fax:712-722-8426
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2021-09-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA43349207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine