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General NPI Number Information
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NPI Number | 1811796360
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Entity Type | Individual
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Provider Name | ALLISON KALI SHELTON-TAHDOOAHNIPPAH OD
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Gender | Female
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | US 191 & HOSPITAL DRIVE
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City | CHINLE
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State | AZ
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Zip | 86503
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Country | US
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Telephone | 928-674-7001
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Fax |
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Provider Business Mailing Address
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Address Line | 916 SW 49TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73109-3826
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Country | US
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Telephone | 405-795-7615
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | OPT.0004116
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License Number State | CO
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