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Individual

RANDAL C. SHELTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
3330 S RIO GRANDE AVE STE 300, MONTROSE, CO 81401-4850
(970) 249-7751
(970) 249-5029
Mailing address
2303 S TOWNSEND AVE STE A, MONTROSE, CO 81401-5452
(970) 249-7751
(970) 249-5029

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
172631
NC
207Q00000X
Family Medicine Physician
Primary
DR.0053162
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
349127YS6E
MEDICARE B PTAN FOR LBN: OLATHE COMMUNITY CLINIC
CO
01
349127YTYK
MEDICARE PTAN SAN JUAN FAMILY MEDICINE
CO
01
349127ZV3Y
MEDICARE B PTAN FOR MTN PEAKS FAMILY PRACTICE
CO
05
91737818
CO
01
P01721833
RAILROAD WORKERS MEDICARE FOR MTN PEAKS FAMILY PRACTICE
Enumeration date
08/05/2011
Last updated
11/25/2024
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