Provider Demographics
NPI:1184717555
Name:SEYMOUR, WILLIAM LESTER (PHD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LESTER
Last Name:SEYMOUR
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:217 W DUNWOOD RD
Mailing Address - Street 2:
Mailing Address - City:FOX POINT
Mailing Address - State:WI
Mailing Address - Zip Code:53217-3176
Mailing Address - Country:US
Mailing Address - Phone:414-988-5354
Mailing Address - Fax:608-833-0126
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:DEPT OF PSYCHIATRY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3518
Practice Address - Country:US
Practice Address - Phone:414-266-2932
Practice Address - Fax:414-266-3735
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2418103T00000X
AZ3407103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39139300Medicaid
WI391369300Medicaid