Provider Demographics
NPI:1437136959
Name:FITZGERALD-SHELTON, KAREN (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:FITZGERALD-SHELTON
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 1:341 COOL SPRINGS BLVD.
Mailing Address - Street 2:STE. 400
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067
Mailing Address - Country:US
Mailing Address - Phone:423-508-7337
Mailing Address - Fax:423-508-7338
Practice Address - Street 1:1602 W. NORTHFIELD BLVD.
Practice Address - Street 2:STE. 504
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-6056
Practice Address - Country:US
Practice Address - Phone:617-217-3321
Practice Address - Fax:615-217-3477
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101055524207W00000X
ALMD.37184207WX0009X, 207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1437136959Medicaid
G11886Medicare UPIN
VA180038805Medicare PIN
VA017354R53Medicare PIN