Provider Demographics
NPI:1750687646
Name:SEAVER, LUCINDA FAYE (RT (R),RDMS,RDCS,RVT)
Entity Type:Individual
Prefix:MRS
First Name:LUCINDA
Middle Name:FAYE
Last Name:SEAVER
Suffix:
Gender:F
Credentials:RT (R),RDMS,RDCS,RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 RAILROAD RD
Mailing Address - Street 2:
Mailing Address - City:WESTPOINT
Mailing Address - State:TN
Mailing Address - Zip Code:38486-5310
Mailing Address - Country:US
Mailing Address - Phone:931-212-2137
Mailing Address - Fax:931-853-4243
Practice Address - Street 1:97 RAILROAD RD
Practice Address - Street 2:
Practice Address - City:WESTPOINT
Practice Address - State:TN
Practice Address - Zip Code:38486-5310
Practice Address - Country:US
Practice Address - Phone:931-212-2137
Practice Address - Fax:931-853-4243
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-10
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMDX00000035332471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3790151Medicaid
TN3790151Medicare PIN