Basic Information
| Provider Information | |||||||||
| NPI: | 1891043956 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BELLISTER | ||||||||
| FirstName: | SETH | ||||||||
| MiddleName: | ALBERT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 225 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | GALAX | ||||||||
| State: | VA | ||||||||
| PostalCode: | 243332228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2762366906 | ||||||||
| FaxNumber: | 2762367179 | ||||||||
| Practice Location | |||||||||
| Address1: | 1211 21ST AVE S # MAB404 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372122717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6159360303 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2012 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | BP10034463 | TX | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0127X | 56337 | TN | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 208600000X | 0101261822 | VA | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.