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General NPI Number Information
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NPI Number | 1679784433
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Entity Type | Organization
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Legal Business Name | SELLERSBURG PEDIATRICS LLC
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 1730 WILLIAMSBURG DRIVE SUITE 3
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-8065
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Country | US
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Telephone | 812-246-0705
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Fax | 812-246-0710
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Provider Business Mailing Address
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Address Line | 1730 WILLIAMSBURG DRIVE SUITE 3
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-8065
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Country | US
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Telephone | 812-246-0705
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Fax | 812-246-0710
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Authorized Official
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Title or Position | OWNER
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Name | DR. SANDRA KAY HENSLEY
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Credential | MD
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Telephone | 812-246-0705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 01043740A
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License Number State | IN
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