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NPI Code Detail

MEDICARE: MARLON LAVELL SHELL M.D.

MEDICARE: MARLON LAVELL SHELL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianMD46470TN

General Provider Information

NPI Number : 1437369386
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLON LAVELL SHELL M.D.
Provider Business Mailing Address
First Line : 648 HARTSVILLE PIKE
Second Line :
City : GALLATIN
State : TN
Zip : 37066-2523
Country : US
Telephone Number : 615-451-9246
Fax Number : 615-575-5040
Provider Business Practice Location Address
First Line : 426 22ND AVE E
Second Line :
City : SPRINGFIELD
State : TN
Zip : 37172-3711
Country : US
Telephone Number : 615-384-0600
Fax Number : 615-384-0645
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2007
Last Update Date : 11/17/2020

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