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NPI Code Detail

MEDICARE: JEFFREY SHEEDY DO

MEDICARE: JEFFREY SHEEDY DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XX0005XSports Medicine (Orthopaedic Surgery) Physician02002791AIN
2207X00000XOrthopaedic Surgery Physician02002791AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00444585OTHERKSRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235120759
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY SHEEDY DO
Provider Business Mailing Address
First Line : 1400 E 9TH ST
Second Line :
City : ROCHESTER
State : IN
Zip : 46975-8931
Country : US
Telephone Number : 574-224-1044
Fax Number : 574-224-1103
Provider Business Practice Location Address
First Line : 1430 E 9TH ST
Second Line :
City : ROCHESTER
State : IN
Zip : 46975-8931
Country : US
Telephone Number : 574-223-9525
Fax Number : 574-223-5847
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2005
Last Update Date : 10/02/2014

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