Provider Demographics
NPI:1679242457
Name:SEEBERGER DERMATOLOGY LLC
Entity Type:Organization
Organization Name:SEEBERGER DERMATOLOGY LLC
Other - Org Name:ALAMOGORDO DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:BONN
Authorized Official - Last Name:SEEBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-841-8300
Mailing Address - Street 1:1401 10TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-5012
Mailing Address - Country:US
Mailing Address - Phone:575-437-4533
Mailing Address - Fax:575-437-5009
Practice Address - Street 1:1401 10TH ST STE C
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-5012
Practice Address - Country:US
Practice Address - Phone:575-405-9886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-07
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty