Individual
TOMMY WARREN SHELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
350 HOSPITAL WAY, SUITE 270, SOMERSET, KY 42503-2872
(606) 425-4298
(606) 425-4299
Mailing address
350 HOSPITAL WAY, SUITE 270, SOMERSET, KY 42503-2872
(606) 425-4298
(606) 425-4299
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
41582
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00675001
MEDICARE PTAN
KY
Enumeration date
03/14/2007
Last updated
01/09/2012
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