Healthcare Provider Details

I. General information

NPI: 1487705968
Provider Name (Legal Business Name): MARK RICHARD SEIGH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2007
Last Update Date: 12/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 E CAMELBACK RD STE 700
SCOTTSDALE AZ
85251-2400
US

IV. Provider business mailing address

1152 SAWGRASS DR
GULF BREEZE FL
32563-3534
US

V. Phone/Fax

Practice location:
  • Phone: 480-809-4829
  • Fax: 623-322-6147
Mailing address:
  • Phone: 240-498-5412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number1162857
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: