Provider Demographics
NPI:1467011213
Name:SIZEMORE, ROBERT SHELTON III (FNP)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:SHELTON
Last Name:SIZEMORE
Suffix:III
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 INTERCHANGE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-7661
Mailing Address - Country:US
Mailing Address - Phone:912-527-5301
Mailing Address - Fax:912-527-5301
Practice Address - Street 1:89 INTERCHANGE DR
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-7661
Practice Address - Country:US
Practice Address - Phone:912-527-5301
Practice Address - Fax:912-527-5301
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23295363LF0000X
GARN232844363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
1467011213OtherURGENT CARE