Individual
MR. JONATHAN RICHARD SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
245 MEDICAL PARK DR STE B, MARION, VA 24354-1100
(276) 378-1000
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110004242
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063859544
—
VA
Enumeration date
05/24/2013
Last updated
08/21/2024
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