Provider Demographics
NPI:1316044605
Name:SEYMOUR, STEPHEN D (DO)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:D
Last Name:SEYMOUR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:337-470-7801
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:5000 AMBASSADOR CAFFERY PKWY BLDG 10
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6984
Practice Address - Country:US
Practice Address - Phone:337-470-7801
Practice Address - Fax:337-470-7800
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS016817207VF0040X
FLOS9903207VG0400X
LADO.000126207VG0400X
LA000126207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1036722Medicaid
LAP00474398OtherRAILROAD MEDICARE
AC882OtherMEDICARE GROUP PTAN
LA4N052DD51Medicare PIN
LA1036722Medicaid
AC882OtherMEDICARE GROUP PTAN