Individual
DR. DONNIE EDWIN SHELTON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 S 14TH ST, HERRIN, IL 62948
(618) 942-2171
(618) 351-4917
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036121910
IL
207Q00000X
Family Medicine Physician
1250520017
IL
Other
Enumeration date
12/13/2006
Last updated
09/28/2021
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