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General NPI Number Information
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NPI Number | 1073584900
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Entity Type | Individual
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Provider Name | ANDREW JACKSON SELLERS MD
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Gender | Male
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 4473 N SADDLE DR
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City | BEVERLY HILLS
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State | FL
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Zip | 34465-4855
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Country | US
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Telephone | 855-687-7237
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Fax |
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Provider Business Mailing Address
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Address Line | 4040 E CAMELBACK RD STE 250
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City | PHOENIX
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State | AZ
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Zip | 85018-8350
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 209761
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 229371
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License Number State | AK
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME136121
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 0101241822
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License Number State | VA
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