Gwendolyn Shelton, MD
Pediatrics in Boonville, IN. Individual provider (NPI-1).
NPI number1285649749
StatusActive
Last updated in NPPESFeb 11, 2025
Details
- NPI
- 1285649749
- Entity type
- Individual (NPI-1)
- Name
- Gwendolyn Shelton
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 30, 2006
- Certification date
- Feb 6, 2025
- Last updated
- Feb 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | 01083878A | IN | Yes |
| 208000000X | Pediatrics | 2002-0294 | NM | |
| 208000000X | Pediatrics | 0420012043 | VT |
Other names
- Gwendolyn S Lattimore (Former Name)
Practice location
1116 Millis AveBoonville, IN 47601-2204
Phone 812-897-7404
Mailing address
1116 Millis AveBoonville, IN 47601-2204
Other practice locations
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