Individual
DR. RICKY LEE SEABUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12033 AGENCY RD, PARKER, AZ 85344-7718
(928) 669-2173
(928) 669-2571
Mailing address
12033 AGENCY RD, PARKER, AZ 85344-7718
(928) 669-2173
(928) 669-2571
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40244-020
WI
207QA0505X
Adult Medicine Physician
40244-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34048300
—
WI
Enumeration date
09/01/2006
Last updated
04/28/2015
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