Healthcare Provider Details

I. General information

NPI: 1326952144
Provider Name (Legal Business Name): CALEB DALE SHELTON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1304 S AURORA ST
ELDON MO
65026-1695
US

IV. Provider business mailing address

20 BONNIE DR
IBERIA MO
65486-9322
US

V. Phone/Fax

Practice location:
  • Phone: 573-392-7303
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberP-23846
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: