Provider Demographics
NPI:1770583692
Name:LUCINDA SEAVER
Entity type:Organization
Organization Name:LUCINDA SEAVER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ULTRASONOGRAPHER
Authorized Official - Prefix:
Authorized Official - First Name:LUCINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:RT(R),RDCS,RDMS,RVT
Authorized Official - Phone:866-724-0465
Mailing Address - Street 1:PO BOX 177
Mailing Address - Street 2:
Mailing Address - City:WESTPOINT
Mailing Address - State:TN
Mailing Address - Zip Code:38486-0177
Mailing Address - Country:US
Mailing Address - Phone:866-724-0465
Mailing Address - Fax:931-853-4243
Practice Address - Street 1:97 RAILROAD RD
Practice Address - Street 2:
Practice Address - City:WESTPOINT
Practice Address - State:TN
Practice Address - Zip Code:38486-5310
Practice Address - Country:US
Practice Address - Phone:866-724-0465
Practice Address - Fax:931-853-4243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-22
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMDX00000035332471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3790151Medicaid
TN3790151Medicaid