Lavern Shelton is a Specialist in Decatur, Georgia. Lavern Shelton practices all healthcare services and medical treatments related to Specialist. The NPI Number for Lavern Shelton is 1891910014. The last update date is 2007-07-08.
Lavern Shelton's current location address is 2301 Wingfoot Pl, Decatur, Georgia. You can contact this provider via phone number 4042986404 and fax number 4045931268. The mailing address for Lavern Shelton is 2301 Wingfoot Pl, Decatur, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Lavern Shelton |
|---|---|
| Address | 2301 Wingfoot Pl, Decatur, Georgia |
| Phone Number | 4042986404 |
| Fax Number | 4045931268 |
| Sole Proprietor | Y |
| Credentials | O.T. |
NPI Number Detail
| NPI Number | 1891910014 |
|---|---|
| Provider Enumeration Date | 2007-04-14 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2301 Wingfoot Pl |
|---|---|
| City | Decatur |
| State | Georgia (GA) |
| Post Code | 300352812 |
| Phone Number | 4042986404 |
| Fax Number | 4045931268 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| O.T. 000696 | GA | LICENSE NO. |
Post Comment/ Review Below
What is the Lavern Shelton's unique identification number?
The Lavern Shelton has been assigned the NPI (National Provider Identifier) Number 1891910014 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you kindly provide the complete physical address where Lavern Shelton's facilities are geographically located?
The facilities of Lavern Shelton are physically situated at the following location: 2301 Wingfoot Pl, Decatur, GA, 300352812.
What is Lavern Shelton's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Lavern Shelton is Specialist, and the corresponding taxonomy classification code for this specialized field is 174400000X.
On what date did Lavern Shelton receive its 1891910014 assignment from the Centers for Medicare & Medicaid Services?
The Lavern Shelton was assigned its 1891910014 on 2007-04-14, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information related to Lavern Shelton most recently updated or refreshed?
The details pertaining to the Lavern Shelton, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-08.
NPI Number: 1336142389
Address: Po Box 2004, East Syracuse, NY