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General NPI Number Information
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NPI Number | 1629870035
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Entity Type | Organization
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Legal Business Name | WOUND CARE MEDICAL MISSISSIPPI LLC
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | ATTN: WOUND CARE MEDICAL MISSISSIPPI LLC 109 EXECUTIVE DRIVE, SUITE 3
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City | MADISON
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State | MS
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Zip | 39110
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Country | US
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Telephone | 737-703-8191
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Fax | 512-243-6916
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Provider Business Mailing Address
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Address Line | 8161 HIGHWAY 100 STE 264
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City | NASHVILLE
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State | TN
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Zip | 37221-4213
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Country | US
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Telephone | 737-703-8191
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Fax | 512-243-6916
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL SEESTADT
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Credential |
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Telephone | 737-703-8191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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