| NPI | 1801063698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMMY WARREN SHELTON Owner/Physician 606-425-4298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2014-03-05 |