Provider Demographics
NPI:1013266758
Name:BURTON, SETH VAUGHAN (ATP)
Entity Type:Individual
Prefix:MR
First Name:SETH
Middle Name:VAUGHAN
Last Name:BURTON
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13213 HWY 155 S STE B
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-6561
Mailing Address - Country:US
Mailing Address - Phone:903-509-4446
Mailing Address - Fax:903-509-4448
Practice Address - Street 1:13213 HWY 155 S STE B
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-6561
Practice Address - Country:US
Practice Address - Phone:903-509-4446
Practice Address - Fax:903-509-4448
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other