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Contact Information

LUCAS SEIBOLT, MD
2409 N PATTERSON ST STE 310
VALDOSTA, GA31602-2512
 Phone: 229-433-8160
 Fax: 229-244-2707
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Cardiology

207RI0011X 11 Physician/Internal Medicine
 

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Computed Tomography Radiologic Technologist

2471C3401X
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Nuclear Cardiology

207UN0901X 36 Physician/Nuclear Medicine
Indicates primary specialty

NPI Profile & details for LUCAS SEIBOLT · (Male)

NPI # 1588074140
Status Active
Credentials MD
Entity Individual
Enumeration date 05/05/2014
Last updated 10/26/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • AZ License # 252293
  • AZ License # 54189
  • AZ License # R74418
  • GA License # 88599
  • IN License # 01083408A
Hospital affiliation(s)
  • SOUTH GEORGIA MEDICAL CENTER - (Acute Care)
    2501 NORTH PATTERSON STREET, PO BOX 1727
    VALDOSTA, GA 31603
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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