Provider Demographics
NPI:1093818536
Name:SHEEDY, JAMES BRIAN (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:BRIAN
Last Name:SHEEDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:J
Other - Middle Name:BRIAN
Other - Last Name:SHEEDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1300 MICCOSUKEE ROAD
Mailing Address - Street 2:PALLIATIVE CARE
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308
Mailing Address - Country:US
Mailing Address - Phone:850-431-6868
Mailing Address - Fax:850-431-6449
Practice Address - Street 1:1300 MICCOSUKEE ROAD
Practice Address - Street 2:PALLIATIVE CARE
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-431-6868
Practice Address - Fax:850-431-6449
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0024142207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00297844AMedicaid
FL053683100Medicaid
FL71391OtherBCBS
FL71391ZMedicare Oscar/Certification
D65541Medicare UPIN