Healthcare Provider Details

I. General information

NPI: 1194344465
Provider Name (Legal Business Name): KARLI KAYE SHELTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARLI KAYE GAGE

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6161 S YALE AVE
TULSA OK
74136-1902
US

IV. Provider business mailing address

4502 E 41ST ST
TULSA OK
74135-2536
US

V. Phone/Fax

Practice location:
  • Phone: 918-502-1900
  • Fax: 918-494-6303
Mailing address:
  • Phone: 918-619-4400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number41627
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: