Sheely, Robert Allen

Sheely, Robert Allen is an individual health care provider with primary practice located at 1220 N Shore Pkwy Ste A , Brandon MS 39047-6383. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Sheely, Robert Allen can be contacted via phone (601) 829-2939.

Contact Information

Primary practice address
1220 N Shore Pkwy Ste A Brandon MS 39047-6383
Phone: (601) 829-2939
Fax: (601) 829-2995
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 17053 Mississippi

Profile Details

NPI number 1104895028
LBN Legal business name Sheely, Robert Allen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Aug 18th, 2020 - about 6 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 1104895028 NPPES
Mississippi Other 7431317 AETNA
Mississippi Other P00074718 AETNA
Mississippi Other 753068151 AETNA
Mississippi Other 753068151 AETNA
Mississippi Other 168390707 AETNA
Mississippi Other 753068151 AETNA
Mississippi Other 753068151002 AETNA
Mississippi MEDICAID 00126023 AETNA

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