Kenneth Trevor Shealy, O.D.

NPI #1104436922 in Tifton, Georgia

Provider Information

NPI Number: 1104436922
Entity Type: Individual
Name: Kenneth Trevor Shealy, O.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: Aug 6, 2020
Last Updated: Aug 23, 2024

Practice Location

Address: 1803 OLD OCILLA RD
City: Tifton
State: Georgia
ZIP Code: 31794-1617
Phone: (229) 386-2181

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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