Provider Demographics
NPI:1194257378
Name:HELTON, MICHELLE ALANE (DO, MBA)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ALANE
Last Name:HELTON
Suffix:
Gender:F
Credentials:DO, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:OSAGE BEACH
Mailing Address - State:MO
Mailing Address - Zip Code:65065-3050
Mailing Address - Country:US
Mailing Address - Phone:573-346-5624
Mailing Address - Fax:
Practice Address - Street 1:1930 N BUSINESS ROUTE 5
Practice Address - Street 2:
Practice Address - City:CAMDENTON
Practice Address - State:MO
Practice Address - Zip Code:65020-2659
Practice Address - Country:US
Practice Address - Phone:573-346-5654
Practice Address - Fax:573-346-1957
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018023719207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program