Individual
DR. CARL RANDOLPH SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3407
(407) 681-2241
(407) 679-2779
Mailing address
6086 AUBURN CT, BURLINGTON, KY 41005-8022
(304) 809-5312
(859) 918-6625
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
16669
WV
208100000X
Physical Medicine & Rehabilitation Physician
Primary
45121
KY
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
16669
WV
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
45121
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100210600
—
KY
Enumeration date
10/03/2005
Last updated
06/09/2025
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