Provider Demographics
NPI:1376540716
Name:SEIBEL, ROY C JR (MD)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:C
Last Name:SEIBEL
Suffix:JR
Gender:M
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:PO BOX 216
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:ME
Mailing Address - Zip Code:04553-0216
Mailing Address - Country:US
Mailing Address - Phone:207-563-3782
Mailing Address - Fax:207-563-6977
Practice Address - Street 1:71 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:ME
Practice Address - Zip Code:04553-3815
Practice Address - Country:US
Practice Address - Phone:207-563-3782
Practice Address - Fax:207-563-6977
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME10514207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C66353Medicare UPIN
015034Medicare ID - Type Unspecified