Provider Demographics
NPI:1235378787
Name:FDSEIFER PLC
Entity Type:Organization
Organization Name:FDSEIFER PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERIC
Authorized Official - Middle Name:D
Authorized Official - Last Name:SEIFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-684-0488
Mailing Address - Street 1:112 AIRPORT BUSINESS PARK ROAD
Mailing Address - Street 2:SUITE D
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-7447
Mailing Address - Country:US
Mailing Address - Phone:931-684-0488
Mailing Address - Fax:931-684-2466
Practice Address - Street 1:112 AIRPORT BUSINESS PARK ROAD
Practice Address - Street 2:SUITE D
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-7447
Practice Address - Country:US
Practice Address - Phone:931-684-0488
Practice Address - Fax:931-684-2466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-06
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19055207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4213638OtherBLUE CROSS BLUE SHIELD