Provider Demographics
NPI:1275622706
Name:SHEEHY, GERALD JOHN III (PA-C)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:JOHN
Last Name:SHEEHY
Suffix:III
Gender:M
Credentials:PA-C
Other - Prefix:MR
Other - First Name:G
Other - Middle Name:JOHN
Other - Last Name:SHEEHY
Other - Suffix:III
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:1100 TUNNEL RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-2576
Mailing Address - Country:US
Mailing Address - Phone:828-298-7911
Mailing Address - Fax:
Practice Address - Street 1:1100 TUNNEL RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-2576
Practice Address - Country:US
Practice Address - Phone:828-298-7911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12582451-1206363A00000X
IL085.002796363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant