Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 38394 | OK |
N | 207XS0106X | Orthopaedic Hand Surgeon | 38394 | OK |
NPI | 1063809358 |
---|---|
Provider Name | William L Shelton |
First Address | Tulsa, OK 74137-4265 |
Second Address | Tulsa, OK 74137-4265 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2015 |
Last Update Date | 09/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200991140A | (05) | OK |