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NPI Code Detail

MEDICARE: SHELBY R WALTERS MD

MEDICARE: SHELBY R WALTERS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician31635MS

General Provider Information

NPI Number : 1447819594
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELBY R WALTERS MD
Provider Business Mailing Address
First Line : 8110 N BROTHER BLVD
Second Line :
City : BARTLETT
State : TN
Zip : 38133-2760
Country : US
Telephone Number : 901-255-5221
Fax Number : 901-373-4511
Provider Business Practice Location Address
First Line : 1204 MEDICAL PARK DR
Second Line :
City : OXFORD
State : MS
Zip : 38655-5326
Country : US
Telephone Number : 662-236-5717
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2019
Last Update Date : 08/14/2023

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