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General NPI Number Information
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NPI Number | 1619027786
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Entity Type | Organization
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Legal Business Name | RICHARD G SELLERS MD PA
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 10/30/2008
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Provider Practice Location Address
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Address Line | 41 FAIRPOINT DR STE B
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City | GULF BREEZE
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State | FL
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Zip | 32561-4380
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Country | US
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Telephone | 850-916-9777
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Fax |
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Provider Business Mailing Address
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Address Line | 41 FAIRPOINT DR STE B
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City | GULF BREEZE
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State | FL
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Zip | 32561-4380
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Country | US
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Telephone | 850-916-9777
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICHARD GRAHAM SELLERS
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Credential | M.D.
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Telephone | 850-916-9777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State | FL
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