Kisa W Seymore, MD - Medicare Family Practice in Cedartown, GA

Kisa W Seymore, MD is a medicare enrolled "Dermatology" physician in Cedartown, Georgia. She went to East Tennessee State University Quillen College Of Medicine and graduated in 2004 and has 20 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Skin Cancer And Cosmetic Dermatology Center Pc and her current practice location is 1025 N Main St, Cedartown, Georgia. You can reach out to her office (for appointments etc.) via phone at (770) 748-0076.

Kisa W Seymore is licensed to practice in Georgia (license number 4221) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1841200375.

Contact Information

Kisa W Seymore, MD
1025 N Main St,
Cedartown, GA 30125-2036
(770) 748-0076
(770) 748-9323



Physician's Profile

Full NameKisa W Seymore
GenderFemale
SpecialityFamily Practice
Experience20 Years
Location1025 N Main St, Cedartown, Georgia
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Kisa W Seymore attended and graduated from East Tennessee State University Quillen College Of Medicine in 2004
  NPI Data:
  • NPI Number: 1841200375
  • Provider Enumeration Date: 08/08/2006
  • Last Update Date: 11/27/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 2163428707
  • Enrollment ID: I20120822000741

Medical Identifiers

Medical identifiers for Kisa W Seymore such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1841200375NPI-NPPES
003125281AMedicaidGA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 4221 (Georgia)Secondary
207N00000XDermatology 4221 (Georgia)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Adventhealth GordonCalhoun, GAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Skin Cancer And Cosmetic Dermatology Center Pc337559120921

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kisa W Seymore allows following entities to bill medicare on her behalf.
Entity NameSkin Cancer & Cosmetic Dermatology Center Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1376605394
PECOS PAC ID: 3375591209
Enrollment ID: O20050107000373

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kisa W Seymore is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kisa W Seymore, MD
420 E 2nd Ave, Suite 103,
Rome, GA 30161-3209

Ph: (706) 509-3000
Kisa W Seymore, MD
1025 N Main St,
Cedartown, GA 30125-2036

Ph: (770) 748-0076

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Dermatology Doctors in Cedartown, GA


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