Provider Demographics
NPI:1437369386
Name:SHELL, MARLON LAVELL (MD)
Entity Type:Individual
Prefix:
First Name:MARLON
Middle Name:LAVELL
Last Name:SHELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:648 HARTSVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-2523
Mailing Address - Country:US
Mailing Address - Phone:615-451-9246
Mailing Address - Fax:615-575-5040
Practice Address - Street 1:426 22ND AVE E
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172-3711
Practice Address - Country:US
Practice Address - Phone:615-384-0600
Practice Address - Fax:615-384-0645
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD46470208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics