Healthcare Provider Details

I. General information

NPI: 1619926680
Provider Name (Legal Business Name): KAREN E. SHELTON M.D., FACOG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 06/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 FRANCIS MARION LN DISTRICT OFFICE, 2ND FLOOR
MARION VA
24354-4227
US

IV. Provider business mailing address

201 FRANCIS MARION LN DISTRICT OFFICE, 2ND FLOOR
MARION VA
24354-4227
US

V. Phone/Fax

Practice location:
  • Phone: 276-781-7450
  • Fax: 276-781-7455
Mailing address:
  • Phone: 276-781-7450
  • Fax: 276-781-7455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number0101260180
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number29105
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: