Provider Demographics
NPI:1235868274
Name:SHEEHAN, ALEX RAY
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:RAY
Last Name:SHEEHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 BEARD RD
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:OH
Mailing Address - Zip Code:43074-8998
Mailing Address - Country:US
Mailing Address - Phone:740-815-3729
Mailing Address - Fax:
Practice Address - Street 1:4550 BEARD RD
Practice Address - Street 2:
Practice Address - City:SUNBURY
Practice Address - State:OH
Practice Address - Zip Code:43074-8998
Practice Address - Country:US
Practice Address - Phone:740-815-3729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program