Provider Demographics
NPI:1689792152
Name:SEELEY, JON E (BS)
Entity Type:Individual
Prefix:MR
First Name:JON
Middle Name:E
Last Name:SEELEY
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 30TH AVE N
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35207-4541
Mailing Address - Country:US
Mailing Address - Phone:205-323-4548
Mailing Address - Fax:205-521-6854
Practice Address - Street 1:5842 SUMPTER DR
Practice Address - Street 2:
Practice Address - City:PINSON
Practice Address - State:AL
Practice Address - Zip Code:35126-3559
Practice Address - Country:US
Practice Address - Phone:205-323-4548
Practice Address - Fax:205-521-6854
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7084183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist