Healthcare Provider Details

I. General information

NPI: 1841629946
Provider Name (Legal Business Name): SETON MEDICAL MANAGEMENT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2013
Last Update Date: 08/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 AIRPORT BLVD SUITE D143
MOBILE AL
36608-6705
US

IV. Provider business mailing address

PO BOX 850489
MOBILE AL
36685-0489
US

V. Phone/Fax

Practice location:
  • Phone: 251-342-3949
  • Fax: 251-631-3361
Mailing address:
  • Phone: 251-342-3949
  • Fax: 251-631-3361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES L. WALKER
Title or Position: PRESIDENT
Credential: MD
Phone: 251-633-8880