Provider Demographics
NPI:1649299017
Name:SELIGSON, DAVID (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SELIGSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E GRAY ST
Mailing Address - Street 2:900
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-3900
Mailing Address - Country:US
Mailing Address - Phone:502-584-8002
Mailing Address - Fax:502-589-0849
Practice Address - Street 1:210 E GRAY ST
Practice Address - Street 2:900
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3900
Practice Address - Country:US
Practice Address - Phone:502-584-8002
Practice Address - Fax:502-589-0849
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY22527207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000077661OtherANTHEM (UNIV ORTHO ASSOC)
KY200043230OtherRAILROAD MEDICARE
KY64225279Medicaid
IN100017820Medicaid
KY1049642OtherPASSPORT (UNIV ORTHO ASSO
KY2432618000OtherPASSPORT ADVANTAGE
KY1049642OtherPASSPORT (UNIV ORTHO ASSO
KY2432618000OtherPASSPORT ADVANTAGE