Provider Demographics
NPI:1740431873
Name:URGENT CARE OF SEYMOUR
Entity Type:Organization
Organization Name:URGENT CARE OF SEYMOUR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLASPY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-519-1552
Mailing Address - Street 1:1130 MEDICAL PL
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274-2640
Mailing Address - Country:US
Mailing Address - Phone:812-519-1552
Mailing Address - Fax:812-519-1774
Practice Address - Street 1:1130 MEDICAL PL
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-2640
Practice Address - Country:US
Practice Address - Phone:812-519-1552
Practice Address - Fax:812-519-1774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty