Healthcare Provider Details

I. General information

NPI: 1144511320
Provider Name (Legal Business Name): LUKE V. SELBY MD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2011
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 SHAWNEE MISSION PKWY
WESTWOOD KS
66205-2003
US

IV. Provider business mailing address

4000 CAMBRIDGE ST # MS 2005
KANSAS CITY KS
66160-8501
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-7750
  • Fax:
Mailing address:
  • Phone: 913-588-7750
  • Fax: 913-945-9300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35.137317
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number35.137317
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: