Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 02002791A | IN |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 02002791A | IN |
NPI | 1235120759 |
---|---|
Provider Name | Jeffrey Sheedy |
First Address | Rochester, IN 46975-8931 |
Second Address | Rochester, IN 46975-8931 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2005 |
Last Update Date | 02/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200384260A | (05) | IN |
H58227 | (02) | IN |
P00444585 | RAILROAD MEDICARE (01) | KS |