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General NPI Number Information
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NPI Number | 1487040093
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Entity Type | Individual
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Provider Name | JOSEPH SEACRIST MD
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Gender | Male
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Dates
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Enumeration Date | 04/09/2015
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Last Update Date | 06/28/2019
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Provider Practice Location Address
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Address Line | 3100 LAMB AVE
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City | RICHMOND
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State | VA
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Zip | 23222-2716
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Country | US
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Telephone | 440-413-6306
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Fax | 440-596-4794
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Provider Business Mailing Address
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Address Line | 3100 LAMB AVE
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City | RICHMOND
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State | VA
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Zip | 23222-2716
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Country | US
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Telephone |
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Fax | 440-596-4794
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 0101261183
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License Number State | VA
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