Healthcare Provider Details

I. General information

NPI: 1255357505
Provider Name (Legal Business Name): JAMES A SEIVWRIGHT M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 S PARK DR STE 2
COLCHESTER VT
05446-5935
US

IV. Provider business mailing address

78 WESTWARD DR
COLCHESTER VT
05446-7203
US

V. Phone/Fax

Practice location:
  • Phone: 802-264-5333
  • Fax:
Mailing address:
  • Phone: 802-878-7280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number0680000246
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: