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Individual

DR. BRANDON CHAD SHELLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
2631 FOOTHILL BLVD, SUITE C, ROCK SPRINGS, WY 82901-4771
(307) 362-9545
(307) 362-9732
Mailing address
2631 FOOTHILL BLVD, SUITE C, ROCK SPRINGS, WY 82901-4771
(307) 362-9545
(307) 362-9732

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
2007005956
MO
213E00000X
Podiatrist
218
SD
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
145
WY
213ES0103X
Foot & Ankle Surgery Podiatrist
2007005956
MO
213ES0103X
Foot & Ankle Surgery Podiatrist
218
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
35666011
BC/BS OF KANSAS
MO
01
5648250001
NORDIAN ADMINISTRATIVE
MO
Enumeration date
05/30/2007
Last updated
06/19/2014
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