Seasly, Thomas P

Seasly, Thomas P is an individual health care provider with primary practice located at 4440 North Portage Avenue , South Bend IN 46628-9570. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Seasly, Thomas P can be contacted via phone (574) 204-6200.

Contact Information

Primary practice address
4440 North Portage Avenue South Bend IN 46628-9570
Phone: (574) 204-6200
Fax: (574) 239-1520
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01037180A Indiana

Profile Details

NPI number 1063402444
LBN Legal business name Seasly, Thomas P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2005
Last updated Aug 3rd, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063402444 NPPES
Indiana MEDICAID 100090980

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