Basic Information
| Provider Information | |||||||||
| NPI: | 1386846566 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SETH | ||||||||
| FirstName: | ALKA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 745 HASKINS RD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | BOWLING GREEN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 434021637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193737607 | ||||||||
| FaxNumber: | 4193537076 | ||||||||
| Practice Location | |||||||||
| Address1: | 950 W WOOSTER ST | ||||||||
| Address2: | |||||||||
| City: | BOWLING GREEN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 434022603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193548900 | ||||||||
| FaxNumber: | 4193537076 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2007 | ||||||||
| LastUpdateDate: | 12/23/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | TRN10100 | FL | N | Allopathic & Osteopathic Physicians | General Practice | 207Q00000X | 35.128820 | OH | N | Allopathic & Osteopathic Physicians | Family Medicine | 208M00000X | 35.128820 | OH | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 146HX | 01 | FL | BCBS | OTHER | 001459600 | 05 | FL | MEDICAID | 0177957 | 05 | OH | MEDICAID |