Roddenbery, Seaborn A

Roddenbery, Seaborn A is an individual health care provider with primary practice located at 1900 10Th Ave Ste 201, Columbus GA 31901-3600. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Roddenbery, Seaborn A can be contacted via phone (706) 984-7400.

Contact Information

Primary practice address
1900 10Th Ave Ste 201 Columbus GA 31901-3600
Phone: (706) 984-7400
Fax: (706) 984-7401
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 063806 Georgia

Profile Details

NPI number 1861683989
LBN Legal business name Roddenbery, Seaborn A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2007
Last updated Jun 27th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861683989 NPPES
Georgia MEDICAID 675260995
Georgia MEDICAID 1067717
Georgia MEDICAID 148772
Georgia Other 202I024575

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