Provider Demographics
NPI:1982795001
Name:SEDDON, JENNIFER LYNN
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LYNN
Last Name:SEDDON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 TILGHMAN DR STE 730
Mailing Address - Street 2:
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28334-5519
Mailing Address - Country:US
Mailing Address - Phone:910-892-2103
Mailing Address - Fax:910-892-2684
Practice Address - Street 1:700 TILGHMAN DR STE 730
Practice Address - Street 2:
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-5519
Practice Address - Country:US
Practice Address - Phone:910-892-2103
Practice Address - Fax:910-892-2684
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29663207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC203539CMedicare PIN
NCC35039Medicare UPIN