Individual
DR. SHELBY OLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
350 STEELES RD, BRISTOL, TN 37620-9532
(423) 844-6700
(423) 844-6703
Mailing address
350 STEELES RD, BRISTOL, TN 37620-9532
(423) 844-6700
(423) 844-6703
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD37267
TN
208000000X
Pediatrics Physician
MD37267
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010098297
—
VA
01
—
145775
ANTHEM
VA
01
—
4088647
BCBS TN PROVIDER #
TN
01
—
P00154678
RAILROAD MEDICARE
TN
Enumeration date
06/24/2005
Last updated
03/02/2010
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