Richard Russell Shelton Jr, MD | |
4095 S Lee St, Buford, GA 30518-3647 | |
(770) 932-8519 | |
(770) 533-4798 |
Full Name | Richard Russell Shelton Jr |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 4095 S Lee St, Buford, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619947769 | NPI | - | NPPES |
302587 | Other | GA | WELLCARE |
52684584 | Other | GA | BCBS |
5402578 | Other | GA | AETNA PPO |
8238671 | Other | GA | CIGNA |
000754157M | Medicaid | GA | |
000754157P | Medicaid | GA | |
000754157Q | Medicaid | GA | |
1939869 | Other | GA | UNITED HEALTHCARE |
302571 | Other | GA | WELLCARE |
000754157N | Medicaid | GA | |
000754157R | Medicaid | GA | |
10032982 | Other | GA | AMERIGROUP |
302567 | Other | GA | WELLCARE |
2276934 | Other | GA | AETNA HMO |
302588 | Other | GA | WELLCARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 043775 (Georgia) | Primary |
Entity Name | The Longstreet Clinic, Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326019977 PECOS PAC ID: 2668465733 Enrollment ID: O20040405001521 |
Mailing Address | Practice Location Address |
---|---|
Richard Russell Shelton Jr, MD Po Box 658, Gainesville, GA 30503-0658 Ph: (770) 718-1122 | Richard Russell Shelton Jr, MD 4095 S Lee St, Buford, GA 30518-3647 Ph: (770) 932-8519 |
Laura Frantz Putnam, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4095 S Lee St, Buford, GA 30518 Phone: 770-932-8519 Fax: 770-533-4798 | |
Scott Gary Parsons, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1435 Broadmoor Blvd, Kaiser Permanente Sugar Hill/buford Medical Center, Buford, GA 30518 Phone: 678-765-5735 Fax: 803-765-9052 | |
Nirmala Bharadwaj, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3700 Ridge Rd, Suite'b', Buford, GA 30519 Phone: 678-804-9398 Fax: 678-804-9415 |