Provider Demographics
NPI:1407731805
Name:SEYMOUR, ALEXANDRA MAE (PA)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:MAE
Last Name:SEYMOUR
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2054 BATESVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-9407
Mailing Address - Country:US
Mailing Address - Phone:678-756-3470
Mailing Address - Fax:
Practice Address - Street 1:2054 BATESVILLE RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-9407
Practice Address - Country:US
Practice Address - Phone:678-756-3470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant