Seales, Thomas Jacob

Seales, Thomas Jacob is an sole proprietor health care provider with primary practice located at 1034 Mar Walt Dr Unit 100 , Fort Walton Beach FL 32547-6637. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery is his primary health care specialty. Seales, Thomas Jacob can be contacted via phone (850) 863-2153.

Contact Information

Primary practice address
1034 Mar Walt Dr Unit 100 Fort Walton Beach FL 32547-6637
Fax:
Website:

Profile Details

NPI number 1104184951
LBN Legal business name Seales, Thomas Jacob
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 30th, 2012
Last updated Jan 28th, 2021 - about 3 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 1104184951 NPPES
Florida MEDICAID 02171200
Florida Other ON9E7
Florida Other 14092927

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