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Individual

THOMAS BERKLEY SHELTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1325 WOLF PARK DR, SUITE 102, GERMANTOWN, TN 38138-1742
(901) 252-3400
(901) 763-4305
Mailing address
1325 WOLF PARK DR, SUITE 103, GERMANTOWN, TN 38138-1742
(901) 252-3411
(901) 763-4305

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
11619
MS
208800000X
Urology Physician
Primary
14342
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0100720
BLUE CROSS
TN
01
02110025100
QUAL CHOICE
01
12940660
PHCS
01
211159
SOUTHERN HEALTH SERVICES
05
3021792
TN
01
381926
HEALTH LINK
01
4666085
AETNA
01
7299460
CIGNA
01
747572
FIRST HEALTH
01
89422
BLUE CROSS AR
Enumeration date
05/02/2006
Last updated
02/05/2013
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