Provider Demographics
NPI:1497184592
Name:SETON MEDICAL MANAGEMENT INC.
Entity Type:Organization
Organization Name:SETON MEDICAL MANAGEMENT INC.
Other - Org Name:PROVIDENCE TILLMANS CORNER OCC MED
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-633-8880
Mailing Address - Street 1:5100 RANGELINE ROAD N
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36619-9504
Mailing Address - Country:US
Mailing Address - Phone:251-378-4000
Mailing Address - Fax:251-378-4006
Practice Address - Street 1:5100 RANGELINE ROAD N
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36619-9504
Practice Address - Country:US
Practice Address - Phone:251-378-4000
Practice Address - Fax:251-378-4006
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SETON MEDICAL MANAGEMENT INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty