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General NPI Number Information
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NPI Number | 1336296219
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Entity Type | Organization
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Legal Business Name | STEVE M. SHELTON O.D.
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 07/02/2012
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Provider Practice Location Address
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Address Line | 1401 WEST RD. MCCS COMPLEX BLDG.1231
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City | CAMP LEJEUNE
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State | NC
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Zip | 28452
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Country | US
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Telephone | 910-451-5249
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Fax | 910-451-5381
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Provider Business Mailing Address
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Address Line | 1021 BEECH TREE RD
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City | JACKSONVILLE
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State | NC
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Zip | 28546-6001
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Country | US
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Telephone | 910-451-5249
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Fax | 910-451-5381
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Authorized Official
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Title or Position | OWNER
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Name | STEVE MICHAEL SHELTON
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Credential | O.D.
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Telephone | 910-451-5249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0999
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License Number State | NC
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