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Individual

CLYDE ALEXANDER SHEEHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1040 B SOUTH MADISON ST., TUPELO, MS 38801
(662) 844-4364
(622) 844-4365
Mailing address
1040 B SOUTH MADISON ST., TUPELO, MS 38801
(662) 844-4364
(662) 844-4365

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
13618
MS
2084P0804X
Child & Adolescent Psychiatry Physician
13618
MS
2084P0804X
Child & Adolescent Psychiatry Physician
14706
AL
2084P0804X
Child & Adolescent Psychiatry Physician
34053
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00112003
MS
Enumeration date
07/12/2005
Last updated
01/30/2014
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