Basic Information
| Provider Information | |||||||||
| NPI: | 1437105913 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SEALE HARRIS CLINIC P C | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | SEALE HARRIS CLINIC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 805 SAINT VINCENTS DR | ||||||||
| Address2: | SUITE 510 | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352051636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2055955504 | ||||||||
| FaxNumber: | 2055923427 | ||||||||
| Practice Location | |||||||||
| Address1: | 805 SAINT VINCENTS DR | ||||||||
| Address2: | SUITE 510 | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352051636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2055955504 | ||||||||
| FaxNumber: | 2055923427 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2006 | ||||||||
| LastUpdateDate: | 01/17/2011 | ||||||||
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| AuthorizedOfficialLastName: | CRENSHAW | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | H. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2055955504 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 207R00000X | AL | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.