Provider Demographics
NPI:1437213857
Name:ACHEY, SETH PATRICK (PA)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:PATRICK
Last Name:ACHEY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL PARK BLVD STE 300E
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-7497
Mailing Address - Country:US
Mailing Address - Phone:423-844-6450
Mailing Address - Fax:423-844-6499
Practice Address - Street 1:1 MEDICAL PARK BLVD STE 300E
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-7497
Practice Address - Country:US
Practice Address - Phone:423-844-6450
Practice Address - Fax:423-844-6499
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009056363A00000X
TN5104363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02407234Medicaid
NY01658846Medicaid
NY0253660002Medicare NSC
NYDD4028Medicare PIN