Shelton, Carl Randolph

Shelton, Carl Randolph is an individual health care provider with primary practice located at 201 Medical Village Dr , Edgewood KY 41017-3407. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is his primary health care specialty. Shelton, Carl Randolph can be contacted via phone (407) 681-2241.

Contact Information

Primary practice address
201 Medical Village Dr Edgewood KY 41017-3407
Phone: (407) 681-2241
Fax: (407) 679-2779
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 16669 West Virginia
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 45121 Kentucky
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 16669 West Virginia
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 45121 Kentucky

Profile Details

NPI number 1588651715
LBN Legal business name Shelton, Carl Randolph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2005
Last updated May 5th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588651715 NPPES
West Virginia MEDICAID 0113641000
West Virginia MEDICAID 7100210600

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