Healthcare Provider Details

I. General information

NPI: 1477723500
Provider Name (Legal Business Name): DENNY W SEYMOUR SR. RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 03/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 COLLEGE AVE
ELBERTON GA
30635-1705
US

IV. Provider business mailing address

101 COLLEGE AVE
ELBERTON GA
30635-1705
US

V. Phone/Fax

Practice location:
  • Phone: 706-283-1701
  • Fax: 706-283-1704
Mailing address:
  • Phone: 706-283-1701
  • Fax: 706-283-1704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9970
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: