Healthcare Provider Details

I. General information

NPI: 1144687088
Provider Name (Legal Business Name): BENJAMIN J SEATON P.A
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2016
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9094 E MINERAL CIR STE 100
CENTENNIAL CO
80112-7201
US

IV. Provider business mailing address

9094 E MINERAL CIR STE 100
CENTENNIAL CO
80112-7201
US

V. Phone/Fax

Practice location:
  • Phone: 303-694-3200
  • Fax: 303-694-2680
Mailing address:
  • Phone: 303-694-3200
  • Fax: 303-694-2680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0004516
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA.0004516
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: