Provider Demographics
NPI:1962652636
Name:SEYMOUR, CARL DYLAN (MHPP)
Entity Type:Individual
Prefix:MR
First Name:CARL
Middle Name:DYLAN
Last Name:SEYMOUR
Suffix:
Gender:M
Credentials:MHPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 MAIN ST STE V
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-4964
Mailing Address - Country:US
Mailing Address - Phone:501-802-5119
Mailing Address - Fax:
Practice Address - Street 1:600 MAIN ST STE V
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-4964
Practice Address - Country:US
Practice Address - Phone:501-321-8200
Practice Address - Fax:501-321-8202
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator