Provider Demographics
NPI:1336875764
Name:SEAL, MADYSAN F (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MADYSAN
Middle Name:F
Last Name:SEAL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27105 MILITARY RD
Mailing Address - Street 2:
Mailing Address - City:ANGIE
Mailing Address - State:LA
Mailing Address - Zip Code:70426-1721
Mailing Address - Country:US
Mailing Address - Phone:985-516-8344
Mailing Address - Fax:
Practice Address - Street 1:1116 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:FRANKLINTON
Practice Address - State:LA
Practice Address - Zip Code:70438-1847
Practice Address - Country:US
Practice Address - Phone:985-839-6381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST024401183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist