Provider Demographics
NPI:1295887271
Name:ROBERT W SEATON, MD PC
Entity type:Organization
Organization Name:ROBERT W SEATON, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:SEATON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-257-5611
Mailing Address - Street 1:200 SUDDERTH DR.
Mailing Address - Street 2:SUITE B
Mailing Address - City:RUIDOSO
Mailing Address - State:NM
Mailing Address - Zip Code:88345
Mailing Address - Country:US
Mailing Address - Phone:505-257-5611
Mailing Address - Fax:505-257-7069
Practice Address - Street 1:200 SUDDERTH DR.
Practice Address - Street 2:SUITE B
Practice Address - City:RUIDOSO
Practice Address - State:NM
Practice Address - Zip Code:88345
Practice Address - Country:US
Practice Address - Phone:505-257-5611
Practice Address - Fax:505-257-7069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM97-140174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1144217563OtherPRIVATE PRACTICE NPI
NM66007526Medicaid
NM66007526Medicaid