Provider Demographics
NPI:1396704268
Name:SHEETS, PATRICK J (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:J
Last Name:SHEETS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:123 S MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER
Mailing Address - State:IN
Mailing Address - Zip Code:47978-2949
Mailing Address - Country:US
Mailing Address - Phone:219-866-1890
Mailing Address - Fax:219-866-1871
Practice Address - Street 1:123 S MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:IN
Practice Address - Zip Code:47978-2949
Practice Address - Country:US
Practice Address - Phone:219-866-1890
Practice Address - Fax:219-866-1871
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01054176207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200502790AMedicaid
INH35845Medicare UPIN
IN184540Medicare ID - Type Unspecified