Provider Demographics
NPI:1891324836
Name:SEAY, CARLOS CORTEZ
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:CORTEZ
Last Name:SEAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 RED HILL CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31825-7514
Mailing Address - Country:US
Mailing Address - Phone:229-887-3609
Mailing Address - Fax:
Practice Address - Street 1:14 RED HILL CHURCH RD
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:GA
Practice Address - Zip Code:31825-7514
Practice Address - Country:US
Practice Address - Phone:229-887-3609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker