Provider Demographics
NPI:1528027596
Name:SHEFFIELD, MIKE (PT)
Entity Type:Individual
Prefix:
First Name:MIKE
Middle Name:
Last Name:SHEFFIELD
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 DULLES DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-2652
Mailing Address - Country:US
Mailing Address - Phone:337-981-9182
Mailing Address - Fax:337-988-3441
Practice Address - Street 1:2115 DULLES DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-2652
Practice Address - Country:US
Practice Address - Phone:337-981-9182
Practice Address - Fax:337-988-3441
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0343225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA650010001 E0303OtherRAILROAD MEDICARE
LAB4436OtherBLUE CROSS/BLUE SHIELD
LA2966015OtherCIGNA
LA70506 A003OtherCHAMPUS
LA2966015OtherCIGNA