Individual
ROBERT ALLEN SHEELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1220 N SHORE PKWY STE A, BRANDON, MS 39047-6383
(601) 829-2939
(601) 829-2995
Mailing address
1220 N SHORE PKWY STE A, BRANDON, MS 39047-6383
(601) 829-2939
(601) 829-2995
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17053
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126023
—
MS
01
—
168390707
US DEPT OF LABOR
MS
01
—
7431317
AETNA
MS
01
—
753068151
1ST CHOICE
MS
01
—
753068151002
TRICARE
MS
01
—
P00074718
RR MEDICARE
MS
Enumeration date
03/14/2006
Last updated
08/18/2020
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