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Individual

MR. SEABORN A RODDENBERY V

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1900 10TH AVE, STE 201, COLUMBUS, GA 31901-3600
(706) 984-7400
(706) 984-7401
Mailing address
1900 10TH AVE, SUITE 201, COLUMBUS, GA 31901-3600
(706) 984-7400
(706) 984-7401

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
063806
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1067717
LA
05
148772
AL
01
202I024575
MEDICARE PTAN
GA
05
675260995
GA
Enumeration date
08/05/2007
Last updated
06/27/2016
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