Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | 28104181A | IN |
NPI | 1477647527 |
---|---|
Provider Name | Ms. Dyan L Sefton |
First Address | Corydon, IN 47112-6437 |
Second Address | Charlestown, IN 47111-9553 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 08/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000286565 | ABCBS PROVIDER # (01) | IN |
1467530931 | SEFTON ANESTHESIA SERVICES GROUP NPI# (01) | IN |
200103090B | (05) | IN |
28104181A | IN LICENSE NUMBER (01) | IN |
430072300 | MEDICARE RAILROAD # (01) | IL |
R93375 | (02) | IN |