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General NPI Number Information
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NPI Number | 1053596338
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Entity Type | Organization
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Legal Business Name | WILLIAM A SHELTON JR MD
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Dates
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Enumeration Date | 01/04/2008
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Last Update Date | 01/04/2008
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Provider Practice Location Address
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Address Line | 821 W DANVILLE ST
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City | SOUTH HILL
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State | VA
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Zip | 23970-3003
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Country | US
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Telephone | 434-447-3637
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Fax | 434-447-5070
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Provider Business Mailing Address
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Address Line | PO BOX 359
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City | SOUTH HILL
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State | VA
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Zip | 23970-0359
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Country | US
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Telephone | 434-447-3637
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Fax | 434-447-5070
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM A SHELTON JR.
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Credential | MD
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Telephone | 434-447-3637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101033377
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License Number State | VA
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