Jared Mark Shelton in Soda Springs - Sports Physician
Jared Mark Shelton - NPI 1457537862
Jared Mark Shelton is a Sports Physician in Soda Springs, Idaho. Jared Mark Shelton practices all healthcare services and medical treatments related to Sports Physician. The NPI Number for Jared Mark Shelton is 1457537862. The last update date is 2008-09-03.
Jared Mark Shelton's current location address is 45 W Center St, Soda Springs, Idaho. You can contact this provider via phone number 2085474518 and fax number 2085474555. The mailing address for Jared Mark Shelton is 45 W Center St, Soda Springs, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jared Mark Shelton |
|---|---|
| Address | 45 W Center St, Soda Springs, Idaho |
| Phone Number | 2085474518 |
| Fax Number | 2085474555 |
| Sole Proprietor | N |
| Credentials | DC, BS, CS |
NPI Number Detail
| NPI Number | 1457537862 |
|---|---|
| Provider Enumeration Date | 2008-01-16 |
| Last Updated Date | 2008-09-03 |
Provider Mailing Address Detail
| Address | 45 W Center St |
|---|---|
| City | Soda Springs |
| State | Idaho (ID) |
| Post Code | 832761530 |
| Phone Number | 2085474518 |
| Fax Number | 2085474555 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Physician |
|---|---|
| Taxonomy | 111Ns0005X |
| Licence No | CHIA-1284 |
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Definition: A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 807952000 | ID | -- | |
| 1673568 | ID | MEDICARE INDIVIDUAL PTAN |
Post Comment/ Review Below
What is the unique identifier code issued to Jared Mark Shelton by the Centers for Medicare & Medicaid Services?
The Jared Mark Shelton has been assigned the NPI (National Provider Identifier) 1457537862. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Jared Mark Shelton is located?
The Jared Mark Shelton is situated at the following address: 45 W Center St, Soda Springs, ID, 832761530.
What is Jared Mark Shelton's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Jared Mark Shelton is Sports Physician, and the corresponding taxonomy classification code for this specialized field is 111Ns0005X.
When was the Jared Mark Shelton's 1457537862 issued?
The Jared Mark Shelton's 1457537862 was issued on 2008-01-16.
When was the information regarding Jared Mark Shelton most recently updated?
The details pertaining to the Jared Mark Shelton, including its address, specialty, and other relevant information, were last refreshed on 2008-09-03.
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