# KELLEY FORD SHIPPEY III

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1245431105
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 35354 | SC | — |
| 207R00000X | Internal Medicine Physician | MED-PHYS-LIC-70337 | MT | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | 35354 | SC | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | 60172 | KY | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | MED-PHYS-LIC-70337 | MT | — |
| 2080S0012X | Pediatric Sleep Medicine Physician | 35354 | SC | — |
| 2080S0012X | Pediatric Sleep Medicine Physician | 60172 | KY | Yes |
| 2080S0012X | Pediatric Sleep Medicine Physician | MED-PHYS-LIC-70337 | MT | — |

## Other

- **Enumeration date:** 05/29/2007
- **Last updated:** 03/21/2025