Provider Demographics
NPI:1083840219
Name:A A SEALES PSC
Entity Type:Organization
Organization Name:A A SEALES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALPHA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SEALES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-491-6411
Mailing Address - Street 1:806 SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-2420
Mailing Address - Country:US
Mailing Address - Phone:859-491-6411
Mailing Address - Fax:859-491-6450
Practice Address - Street 1:806 SCOTT ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011-2420
Practice Address - Country:US
Practice Address - Phone:859-491-6411
Practice Address - Fax:859-491-6450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY17938207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty