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Individual

CHARLES I SHELTON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1350 BULL LEA RD, LEXINGTON, KY 40511-1247
(859) 246-8000
(859) 246-8043
Mailing address
1350 BULL LEA RD, LEXINGTON, KY 40511-1247
(859) 246-8000
(859) 246-8043

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
02282
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011071
STATE MEDICAL BOARD OF OHIO
OH
01
02282
LICENSE NUMBER
KY
Enumeration date
09/07/2006
Last updated
09/24/2014
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