DR. THURMOND ERIC SICELOFF DPM NPI 1164425013

NPI Information

DR. Thurmond Eric Siceloff, DPM is a primary podiatric medicine podiatrist in Clemmons, NC with 29 years of experience. DR. Thurmond Eric Siceloff, DPM NPI is 1164425013. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Graduation Year:1995

The provider's business location address is:

6341 COOK AVE
CLEMMONS, NC
ZIP 27012
Phone: (336) 766-4800
Fax: (336) 766-8486

The NPI 1164425013 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 5/24/2005 and was last updated on 6/15/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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