Innis-Shelton, Racquel D

Innis-Shelton, Racquel D is an individual health care provider with primary practice located at 619 19Th St S , Birmingham AL 35249-1900. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Hematology & Oncology. Allopathic & Osteopathic Physicians / Hematology & Oncology is her primary health care specialty. Innis-Shelton, Racquel D can be contacted via phone (205) 934-4011.

Contact Information

Primary practice address
619 19Th St S Birmingham AL 35249-1900
Phone: (205) 934-4011
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 0116018506 Virginia
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 28895 Alabama
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 28895 Alabama

Profile Details

NPI number 1356553408
LBN Legal business name Innis-Shelton, Racquel D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2007
Last updated Jan 31st, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356553408 NPPES
Mississippi MEDICAID 04523704
Mississippi MEDICAID 110873
Mississippi Other 051598339
Mississippi Other 051598340
Mississippi MEDICAID 110794
Mississippi Other 051598336
Mississippi MEDICAID 110861
Mississippi MEDICAID 110869
Mississippi Other 051598338
Mississippi Other 102I014862

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