Healthcare Provider Details

I. General information

NPI: 1689769929
Provider Name (Legal Business Name): JOHN HOOTON SEWARD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3511 SADDLEBROOK CT
BLOOMINGTON IN
47401-8549
US

IV. Provider business mailing address

3511 SADDLEBROOK CT
BLOOMINGTON IN
47401-8549
US

V. Phone/Fax

Practice location:
  • Phone: 812-331-0732
  • Fax: 812-332-3472
Mailing address:
  • Phone: 812-331-0732
  • Fax: 812-332-3472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number01034422A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: