Provider Demographics
NPI:1013346113
Name:SETON MEDICAL MANAGEMENT INC.
Entity Type:Organization
Organization Name:SETON MEDICAL MANAGEMENT INC.
Other - Org Name:SMARTHEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-633-8880
Mailing Address - Street 1:PO BOX 850489
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36685-0489
Mailing Address - Country:US
Mailing Address - Phone:251-342-3949
Mailing Address - Fax:251-631-3361
Practice Address - Street 1:6701 AIRPORT BLVD
Practice Address - Street 2:SUITE C132
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-6705
Practice Address - Country:US
Practice Address - Phone:251-631-3501
Practice Address - Fax:251-631-3504
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SETON MEDICAL MANAGEMENT INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty