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General NPI Number Information
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NPI Number | 1811642374
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Entity Type | Individual
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Provider Name | LEX EDWARD SEAFORD PA-C
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Gender | Male
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Dates
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Enumeration Date | 02/14/2022
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Last Update Date | 02/14/2022
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Provider Practice Location Address
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Address Line | 101 S RAVENEL ST STE 270
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City | FLORENCE
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State | SC
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Zip | 29506-2624
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Country | US
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Telephone | 843-777-7020
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Fax |
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Provider Business Mailing Address
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Address Line | 2805 KINLOCH CT APT I
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City | FLORENCE
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State | SC
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Zip | 29501-2026
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Country | US
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Telephone | 980-621-3096
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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