Provider Demographics
NPI:1629134093
Name:SEIGLE, MARCUS H (DC)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:H
Last Name:SEIGLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 VIRGINIA AVE S
Mailing Address - Street 2:
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31794-8022
Mailing Address - Country:US
Mailing Address - Phone:229-894-4338
Mailing Address - Fax:
Practice Address - Street 1:118 PHILEMA RD
Practice Address - Street 2:SUITE E
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1253
Practice Address - Country:US
Practice Address - Phone:229-894-4338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2659111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU22564Medicare UPIN
GA35ZCCXPMedicare ID - Type Unspecified