Individual
DR. ANTHONY LEE SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1214 ARLINGTON ST, ADA, OK 74820-4045
(580) 436-5111
(580) 436-1159
Mailing address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-3286
(580) 925-2362
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34719
OK
208000000X
Pediatrics Physician
34719
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34719
OKLAHOMA BOARD OF MEDICAL LICENSURE AND SUPERVISION
OK
Enumeration date
06/17/2019
Last updated
10/18/2023
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