| Dr Donnie Edwin Shelton Jr, MD | |
|
201 S 14th St, Herrin, IL 62948 | |
| (618) 942-2171 | |
| (618) 351-4917 |
| Full Name | Dr Donnie Edwin Shelton Jr |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 201 S 14th St, Herrin, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346301025 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 1250520017 (Illinois) | Secondary |
| 207P00000X | Emergency Medicine | 036121910 (Illinois) | Primary |
| Entity Name | Southern Illinois Medical Services Nfp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770656837 PECOS PAC ID: 3678677390 Enrollment ID: O20070404000595 |
| Entity Name | Integritas Emergency Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790128817 PECOS PAC ID: 7113167446 Enrollment ID: O20130710000760 |
| Entity Name | Statera Health Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043874449 PECOS PAC ID: 0244565729 Enrollment ID: O20190708000284 |
| Entity Name | Deaconess Illinois Specialty Clinic, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972210235 PECOS PAC ID: 9830562016 Enrollment ID: O20230321001688 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Donnie Edwin Shelton Jr, MD Po Box 3988, Carbondale, IL 62902-3988 Ph: (618) 457-5200 | Dr Donnie Edwin Shelton Jr, MD 201 S 14th St, Herrin, IL 62948 Ph: (618) 942-2171 |
Levite Judah Biddle, PARAMEDIC Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 3224 S Park Ave, Herrin, IL 62948 Phone: 618-740-0949 | |
Dr. Alan John Wilson, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 201 S 14th St, Herrin, IL 62948 Phone: 618-942-2171 Fax: 618-351-4917 | |
Dr. Eric A Ruebke, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 201 S 14th St, Herrin, IL 62948 Phone: 618-942-2171 Fax: 618-988-6186 | |
Jaswant S Sidhu, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 201 S 14th St, Herrin, IL 62948 Phone: 618-942-2171 Fax: 618-351-4917 | |
Dobroslawa Reschke, MD Emergency Medicine Medicare: May Accept Medicare Assignments Practice Location: 201 S 14th St, Herrin, IL 62948 Phone: 618-942-2171 Fax: 618-351-4917 | |
Dr. Joshua James Miksanek, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 201 S 14th St, Herrin, IL 62948 Phone: 618-942-2171 Fax: 618-988-6186 | |
Scott Wesley Cranick, PA-C Emergency Medicine Medicare: Medicare Enrolled Practice Location: 201 S 14th St, Herrin, IL 62948 Phone: 618-942-2171 Fax: 618-351-4917 |