Provider Demographics
NPI:1518049980
Name:SHEFFIELD, DAVID S (OD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:SHEFFIELD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2464 W MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-6411
Mailing Address - Country:US
Mailing Address - Phone:334-792-2020
Mailing Address - Fax:334-712-2020
Practice Address - Street 1:2464 W MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-6411
Practice Address - Country:US
Practice Address - Phone:334-792-2020
Practice Address - Fax:334-712-2020
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS422 TA173152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000059840Medicaid
AL000059840Medicaid
000059840Medicare ID - Type Unspecified