Doctor Name: | JASON RANDALL SEALE |
NPI Number: | 1275785180 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 1405 7th St Se Post Office Box 1029 Decatur, AL - 356013341 |
Business Phone Number: | 2563556414 |
Business Fax Number: | |
Mailing Address: | Post Office Box 1029, DECATUR |
State: | AL |
Postal Code: | 356021029 |
Phone Number: | 2563556414 |
Fax Number: | |
NPI Enumeration Date: | 10/22/2008 |
NPI Last Update Date: | 06/06/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |