Healthcare Provider Details

I. General information

NPI: 1346454360
Provider Name (Legal Business Name): JAMES SEGO DO INTERNAL MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 STUART RD NE SUITE 106
CLEVELAND TN
37312-5858
US

IV. Provider business mailing address

PO BOX 294
GEORGETOWN TN
37336-0294
US

V. Phone/Fax

Practice location:
  • Phone: 423-472-5915
  • Fax: 423-339-2321
Mailing address:
  • Phone: 423-472-5915
  • Fax: 423-339-2321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: JAMES W SEGO
Title or Position: OWNER PHYSICIAN
Credential: DO
Phone: 423-472-5915