Provider Demographics
NPI:1063517522
Name:SEIKEL, STACY ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:STACY
Middle Name:ELIZABETH
Last Name:SEIKEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 MT SINAI DR
Mailing Address - Street 2:
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30533
Mailing Address - Country:US
Mailing Address - Phone:800-423-4673
Mailing Address - Fax:
Practice Address - Street 1:330 MT SINAI DR
Practice Address - Street 2:
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533
Practice Address - Country:US
Practice Address - Phone:800-423-4673
Practice Address - Fax:706-482-2059
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME56583207L00000X
GA74357207LA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL062602300Medicaid
FLE75867Medicare UPIN