MEDICARE: JAMES SEGO DO INTERNAL MEDICINE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	173000000X	Legal Medicine

General Provider Information

NPI Number	:	1346454360
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES SEGO DO INTERNAL MEDICINE

Provider Business Mailing Address
First Line	:	PO BOX 294
Second Line	:
City	:	GEORGETOWN
State	:	TN
Zip	:	37336-0294
Country	:	US
Telephone Number	:	423-472-5915
Fax Number	:	423-339-2321

Provider Business Practice Location Address
First Line	:	1510 STUART RD NE
Second Line	:	SUITE 106
City	:	CLEVELAND
State	:	TN
Zip	:	37312-5858
Country	:	US
Telephone Number	:	423-472-5915
Fax Number	:	423-339-2321

Authorized Official
Title or Position	:	OWNER PHYSICIAN
Name	:	JAMES W SEGO
Credential	:	DO
Telephone Number	:	423-472-5915

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	08/22/2020

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