Provider Demographics
NPI:1033234315
Name:SHEFFIELD, JERI LYNN (DO)
Entity Type:Individual
Prefix:DR
First Name:JERI
Middle Name:LYNN
Last Name:SHEFFIELD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4066 FOXBOROUGH BLVD
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-6740
Mailing Address - Country:US
Mailing Address - Phone:229-247-1163
Mailing Address - Fax:229-249-9799
Practice Address - Street 1:3548B NORTHCROSSING CIR
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1067
Practice Address - Country:US
Practice Address - Phone:229-249-9299
Practice Address - Fax:229-249-9799
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA047945207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAHO5436Medicare UPIN
GA08BBSLRMedicare ID - Type Unspecified