Provider Demographics
NPI:1861424228
Name:SHELBY, CHRISTOPHER LINDON (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LINDON
Last Name:SHELBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7843 YOUREE DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5505
Mailing Address - Country:US
Mailing Address - Phone:318-212-3937
Mailing Address - Fax:318-212-3769
Practice Address - Street 1:7843 YOUREE DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5505
Practice Address - Country:US
Practice Address - Phone:318-212-3937
Practice Address - Fax:318-212-3769
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA025412207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1578819Medicaid
LA4F257CS65Medicare PIN
LA1578819Medicaid