Provider Demographics
NPI:1144284951
Name:SHEDDEN, ROBERT D (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:SHEDDEN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:318 WESTGATE PKWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-2963
Mailing Address - Country:US
Mailing Address - Phone:334-702-9445
Mailing Address - Fax:334-702-9465
Practice Address - Street 1:318 WESTGATE PKWY
Practice Address - Street 2:SUITE 2
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-2963
Practice Address - Country:US
Practice Address - Phone:334-702-9445
Practice Address - Fax:334-702-9465
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2013-03-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ALD0118204C00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALD0118OtherALABAMA LICENSE NUMBER
GA22334OtherGEORGIA STATE LICENSE
GA22334OtherGEORGIA STATE LICENSE