Provider Demographics
NPI:1376841825
Name:SEYMOUR, KELLY C (MS, PA-C)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:C
Last Name:SEYMOUR
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Gender:F
Credentials:MS, PA-C
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Mailing Address - Street 1:1010 HORSHAM RD STE 210
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-1500
Mailing Address - Country:US
Mailing Address - Phone:215-853-3434
Mailing Address - Fax:215-672-6566
Practice Address - Street 1:1010 HORSHAM RD STE 210
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-1500
Practice Address - Country:US
Practice Address - Phone:215-853-3434
Practice Address - Fax:215-672-6566
Is Sole Proprietor?:No
Enumeration Date:2011-03-08
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00223300363A00000X
PAMA053688363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant