Provider Demographics
NPI:1457347536
Name:SEYMOUR, JOHN WARREN (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:WARREN
Last Name:SEYMOUR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:VA
Mailing Address - Zip Code:22960-1534
Mailing Address - Country:US
Mailing Address - Phone:434-985-1825
Mailing Address - Fax:540-661-5010
Practice Address - Street 1:130 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:VA
Practice Address - Zip Code:22960-1534
Practice Address - Country:US
Practice Address - Phone:540-661-5006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202006917183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist