Provider Demographics
NPI:1174272462
Name:SEYMOUR, MCKAYLA (DPM)
Entity Type:Individual
Prefix:
First Name:MCKAYLA
Middle Name:
Last Name:SEYMOUR
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23473 SEYMOUR LN
Mailing Address - Street 2:
Mailing Address - City:EPWORTH
Mailing Address - State:IA
Mailing Address - Zip Code:52045-9615
Mailing Address - Country:US
Mailing Address - Phone:563-451-6541
Mailing Address - Fax:
Practice Address - Street 1:2790 GODWIN BLVD, ATTN: RICHARD BRUNO
Practice Address - Street 2:SUITE 355
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434
Practice Address - Country:US
Practice Address - Phone:757-983-8520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program