Individual
MS. SHANNON M URTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
4535 DRESSLER RD NW, CANTON, OH 44718-2545
(855) 687-0618
Mailing address
3208 GOLDEN FOX TRL, LEBANON, OH 45036-8218
(513) 836-3686
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50001452
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000392637
ANTHEM
OH
01
—
415841
WELLCARE
OH
Enumeration date
07/13/2005
Last updated
01/18/2023
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