Healthcare Provider Details

I. General information

NPI: 1861775983
Provider Name (Legal Business Name): WALTER RHODES SEEGER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2011
Last Update Date: 09/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S LIBERTY ST
WAYNESBORO GA
30830-1501
US

IV. Provider business mailing address

400 S LIBERTY ST
WAYNESBORO GA
30830-1501
US

V. Phone/Fax

Practice location:
  • Phone: 706-437-7977
  • Fax:
Mailing address:
  • Phone: 706-437-7977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH010592
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: