Provider Demographics
NPI:1285679084
Name:SEELBACH, ELIZABETH BERRY (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:BERRY
Last Name:SEELBACH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ROSE ST
Mailing Address - Street 2:KENTUCKY CHILDREN'S HOSPITAL
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0001
Mailing Address - Country:US
Mailing Address - Phone:859-323-5741
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:KENTUCKY CHILDREN'S HOSPITAL
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-323-5741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY45634208000000X, 208M00000X
MDD006712208000000X
DCMD037147208000000X
AZ33397208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
I28916Medicare UPIN