Provider Demographics
NPI:1760466619
Name:SEEGAR, JOHN KING B E III (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN KING
Middle Name:B E
Last Name:SEEGAR
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WV
Mailing Address - Zip Code:26807-0100
Mailing Address - Country:US
Mailing Address - Phone:304-358-2355
Mailing Address - Fax:304-358-3054
Practice Address - Street 1:314 PINE ST
Practice Address - Street 2:PENDLETON COMMUNITY CARE INC
Practice Address - City:FRANKLIN
Practice Address - State:WV
Practice Address - Zip Code:26807-0100
Practice Address - Country:US
Practice Address - Phone:304-358-2355
Practice Address - Fax:304-358-3054
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV15282208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001714348OtherMS BCBS
WV3810000282Medicaid
WV2020781Medicare PIN
WV001714348OtherMS BCBS
WVWV2972C551Medicare PIN
WV3810000282Medicaid