Provider Demographics
NPI:1366470494
Name:SEABOLD, LINDA J (PA-C)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:J
Last Name:SEABOLD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:111 FRANKLIN HEALTH CMNS
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938-6144
Mailing Address - Country:US
Mailing Address - Phone:207-779-2628
Mailing Address - Fax:207-779-2303
Practice Address - Street 1:181 FRANKLIN HEALTH COMMONS
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-6144
Practice Address - Country:US
Practice Address - Phone:207-778-3326
Practice Address - Fax:207-778-3102
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2013-04-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MEPA094363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEAP0581Medicare ID - Type Unspecified
MES31273Medicare UPIN