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General NPI Number Information
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NPI Number | 1215125182
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Entity Type | Organization
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Legal Business Name | DRS SEABAUGH AND CRITCH
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Dates
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Enumeration Date | 10/04/2007
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Last Update Date | 11/05/2007
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Provider Practice Location Address
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Address Line | 274 S MOUNT AUBURN RD
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63703-4918
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Country | US
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Telephone | 573-651-4848
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Fax |
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Provider Business Mailing Address
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Address Line | 274 S MOUNT AUBURN RD
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63703-4918
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Country | US
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Telephone | 573-651-4848
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Fax |
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Authorized Official
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Title or Position | OFFICE MGR
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Name | DIANE CRITCHLOW
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Credential |
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Telephone | 573-651-4848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 36516
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License Number State | MO
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