1255379285 NPI number — DR. WENDY L SEAVER M.D.

Table of content: DR. WENDY L SEAVER M.D. (NPI 1255379285)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255379285 NPI number — DR. WENDY L SEAVER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SEAVER
Provider First Name:
WENDY
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255379285
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/07/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 52404
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAFAYETTE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70505-2404
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-429-5071
Provider Business Mailing Address Fax Number:
256-429-4674

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 HOSPITAL DR SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTSVILLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35801-6455
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-880-4187
Provider Business Practice Location Address Fax Number:
256-880-4797
Provider Enumeration Date:
06/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  MD.25430 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207LP2900X , with the licence number: MD.25430 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00121591 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 515-30882 . This is a "BLUE CROSS PHYSICIAN BASD" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 051554147 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 515-17676 . This is a "BLUE CROSS HOSPITAL BASED" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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