Individual
JEFFREY WAYNE SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
21236 LAKE SHADOWS DR, EDMOND, OK 73012-2069
(405) 200-2663
Mailing address
21236 LAKE SHADOWS DR, EDMOND, OK 73012-2069
(405) 200-2663
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
24151
OK
2085R0202X
Diagnostic Radiology Physician
Primary
24151
OK
Other
Enumeration date
02/06/2007
Last updated
05/02/2012
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