Individual
KENNETH TREVOR SHEALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1803 OLD OCILLA RD, TIFTON, GA 31794-1617
(229) 386-2181
(229) 386-2193
Mailing address
1803 OLD OCILLA RD, TIFTON, GA 31794-1617
(229) 386-2181
(229) 386-2193
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT003252
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPT003252
OPTOMETRY LICENSE
GA
Enumeration date
08/06/2020
Last updated
08/23/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us