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General NPI Number Information
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NPI Number | 1821945155
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Entity Type | Individual
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Provider Name | MR. JAYVAUGHN ROBERT SEYMOUR-GREENE
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Gender | Male
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 1645 NEIL AVE
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City | COLUMBUS
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State | OH
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Zip | 43210-1218
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Country | US
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Telephone | 614-293-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 180 LIBERTY ST APT 6436
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City | COLUMBUS
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State | OH
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Zip | 43215-5844
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Country | US
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Telephone | 216-600-6971
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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