Kenneth Trevor Shealy is a Tifton, Georgia based male Optometrist with 4 years of experience in Optometry. He completed his graduation from Southern College Of Optometry in 2020. He accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Kenneth Trevor Shealy is OPT003252 for Optometry in Georgia. Kenneth Trevor Shealy examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. He completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. He is a eye health care professional who is state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Complete Profile:
Kenneth Trevor Shealy speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Specialization:
Optometry
Credentials:
O.D.
Experience:
4+ years
Medical School Attended:
Southern College Of Optometry
Graduation Year:
2020
Gender:
Male
Accepts Medicare Assignment:
Yes
Practice Address:
1803 Old Ocilla Rd, Tifton, Georgia, 31794-1617
Phone:
229-386-2181
Fax:
229-386-2193
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
PAC ID:
7618388570
Enrollment ID:
I20201124003123
NPI Number:
1104436922
NPI Enumeration Date:
06 Aug, 2020
NPI Last Update On:
23 Aug, 2024
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Kenneth Trevor Shealy are as mentioned below.
License Number
Specialization
State
Status
OPT003252
Optometry
Georgia
Primary
Group Practice:
Group practices are run by a group of physicians who share their premises and other resources. Following list states all the group name
with which Kenneth Trevor Shealy has association with along with the number of members in that group.
Organization Name (Group PAC ID)
Members
Fitzgerald Family Eye Care Pc (5193762912)
2
Other Medical Identifiers:
Other legacy medical identifiers associated with Kenneth Trevor Shealy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
OPT003252
Other
Georgia
OPTOMETRY LICENSE
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
1803 Old Ocilla Rd, Tifton, Georgia
Zip:
31794-1617
Phone Number:
229-386-2181
Fax Number:
229-386-2193
Patients can reach Kenneth Trevor Shealy at 1803 Old Ocilla Rd, Tifton, Georgia or can call to book an appointment on 229-386-2181. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 September, 2024.