Provider Demographics
NPI:1083646905
Name:SEATON, ANTHONY D (MD, PHD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:D
Last Name:SEATON
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 W RAVINE RD
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-3847
Mailing Address - Country:US
Mailing Address - Phone:423-246-7372
Mailing Address - Fax:423-578-4369
Practice Address - Street 1:4 SHERIDAN SQ
Practice Address - Street 2:SUITE 102
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-7435
Practice Address - Country:US
Practice Address - Phone:423-246-8196
Practice Address - Fax:423-246-2308
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27984207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6304052Medicaid
VA6304052Medicaid
TN103I180203Medicare PIN
3804872Medicare ID - Type Unspecified
TN103I185048Medicare PIN