Healthcare Provider Details

I. General information

NPI: 1154548717
Provider Name (Legal Business Name): SARAH ANN SEELEY-DICK D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

391 FALLS DR NW
ABINGDON VA
24210-8093
US

IV. Provider business mailing address

PO BOX 9
KINGSPORT TN
37662-0009
US

V. Phone/Fax

Practice location:
  • Phone: 276-739-2920
  • Fax: 276-739-2921
Mailing address:
  • Phone: 423-857-2066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2016
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: