Individual
DR. JEFFREY CHARLES SHELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000777
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0618000777
VIRGINIA OD LICENSE
VA
01
—
11527372
CAQH PROVIDER ID
VA
01
—
152W00000X
NPI
VA
01
—
159000
ANTHEM
VA
Enumeration date
07/04/2006
Last updated
04/12/2025
Update your record
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