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Individual

JAMES R SEIBOLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
263 FARMINGTON AVE, MARB MC5353 RM N3020, FARMINGTON, CT 06030-0002
(860) 679-3605
(860) 679-1042
Mailing address
65 KANE ST, PROVIDER ENROLLMENT - ELLIE ATKINS, WEST HARTFORD, CT 06119-2110
(860) 523-6421
(860) 523-3701

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
048454
CT
207RR0500X
Rheumatology Physician
Primary
048454
CT

Other

Enumeration date
10/25/2006
Last updated
05/06/2010
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