Healthcare Provider Details

I. General information

NPI: 1679680961
Provider Name (Legal Business Name): DOXEY RANSOM SHELDON DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. DOXEY SHELDON CAMPBELL

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 S. LINDBERGH BLVD
ST. LOUIS MO
63131-2824
US

IV. Provider business mailing address

809 S. LINDBERGH BLVD
ST. LOUIS MO
63131-2824
US

V. Phone/Fax

Practice location:
  • Phone: 314-991-0103
  • Fax: 314-991-5417
Mailing address:
  • Phone: 314-991-0103
  • Fax: 314-991-5417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberMO 13205
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: