Provider Demographics
NPI:1568069748
Name:JAUSSEN, SETH LIAM (PA-C)
Entity Type:Individual
Prefix:MR
First Name:SETH
Middle Name:LIAM
Last Name:JAUSSEN
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:461 WESTERN BLVD STE 122
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-7637
Mailing Address - Country:US
Mailing Address - Phone:910-333-2335
Mailing Address - Fax:910-333-0513
Practice Address - Street 1:461 WESTERN BLVD STE 122
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7637
Practice Address - Country:US
Practice Address - Phone:910-333-0283
Practice Address - Fax:910-333-0513
Is Sole Proprietor?:No
Enumeration Date:2020-10-01
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-10657363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical