Provider Demographics
NPI:1326116443
Name:SEILER, KELLY J (MD)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:J
Last Name:SEILER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:J
Other - Last Name:SHEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8331 N DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-6094
Mailing Address - Country:US
Mailing Address - Phone:850-505-4700
Mailing Address - Fax:850-505-4756
Practice Address - Street 1:8331 N DAVIS HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-6094
Practice Address - Country:US
Practice Address - Phone:850-505-4700
Practice Address - Fax:850-505-4756
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1333152080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
175150032OtherMEDICARE
MO1326116443Medicaid
IA1326116443Medicaid