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Individual

RANDALL LOREN SEEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
12050 FALCON HWY, PEYTON, CO 80831-8076
(719) 632-5700
Mailing address
3205 N ACADEMY BLVD, SUITE 130, COLORADO SPRINGS, CO 80917-5101
(719) 632-5700

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3180
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1096781
NCCPA CERTIFICATION
01
3180
COLORADO PHYSICIAN ASSISTANT STATE LICENSE
CO
05
57838275
CO
01
COA108483
MEDICARE NUMBER
CO
Enumeration date
03/14/2011
Last updated
04/05/2017
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