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General NPI Number Information
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NPI Number | 1013081942
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Entity Type | Individual
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Provider Name | JONATHAN SEHY M.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 02/07/2011
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Provider Practice Location Address
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Address Line | 6800 STATE ROUTE 162 ANDERSON HOSPITAL, DEPT. OF RADIOLOGY
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City | MARYVILLE
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State | IL
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Zip | 62062-8500
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Country | US
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Telephone | 314-359-3166
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Fax |
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Provider Business Mailing Address
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Address Line | 6800 STATE ROUTE 162 ANDERSON HOSPITAL, DEPT. OF RADIOLOGY
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City | MARYVILLE
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State | IL
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Zip | 62062-8500
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Country | US
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Telephone | 314-359-3166
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2004014818
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 036.122442
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License Number State | IL
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