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General NPI Number Information
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NPI Number | 1124027313
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Entity Type | Individual
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Provider Name | RONALD EDWARD SELLERS OD
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Gender | Male
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 02/29/2008
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Provider Practice Location Address
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Address Line | 1515 LAWRIE TATUM RD
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City | LAWTON
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State | OK
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Zip | 73507
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Country | US
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Telephone | 580-353-0350
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Fax | 580-355-6234
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Provider Business Mailing Address
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Address Line | 1515 LAWRIE TATUM RD
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City | LAWTON
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State | OK
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Zip | 73507
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Country | US
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Telephone | 580-353-0350
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Fax | 580-355-6234
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 12023
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License Number State | KS
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