Healthcare Provider Details
I. General information
NPI: 1750687646
Provider Name (Legal Business Name): LUCINDA FAYE SEAVER RT (R),RDMS,RDCS,RVT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/10/2011
Last Update Date: 09/05/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
80 RAILROAD RD
WESTPOINT TN
38486-5309
US
IV. Provider business mailing address
80 RAILROAD RD
WESTPOINT TN
38486-5309
US
V. Phone/Fax
- Phone: 931-212-2137
- Fax: 931-853-4243
- Phone: 931-212-2137
- Fax: 931-853-4243
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085U0001X |
| Taxonomy | Diagnostic Ultrasound Physician |
| License Number | MDX000003533 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2471S1302X |
| Taxonomy | Sonography Radiologic Technologist |
| License Number | MDX0000003533 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: