MEDICARE: DR. JAMES E SEELEY III MD

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	207Q00000X	Family Medicine Physician	MD011886	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	77305	OTHER	TN	BLUE CROSS

General Provider Information

NPI Number	:	1568448736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES E SEELEY III MD

Provider Business Mailing Address
First Line	:	1903 OLD HICKORY BLVD
Second Line	:
City	:	OLD HICKORY
State	:	TN
Zip	:	37138-2856
Country	:	US
Telephone Number	:	615-847-5078
Fax Number	:	615-847-0221

Provider Business Practice Location Address
First Line	:	1903 OLD HICKORY BLVD
Second Line	:
City	:	OLD HICKORY
State	:	TN
Zip	:	37138-2856
Country	:	US
Telephone Number	:	615-847-5078
Fax Number	:	615-847-0221

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2005
Last Update Date	:	06/21/2011

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