MEDICARE: DR. ANDREW JACKSON SELLERS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	209761	MA
2	2085R0202X	Diagnostic Radiology Physician	229371	AK
3	2085R0202X	Diagnostic Radiology Physician	ME136121	FL
4	2085R0202X	Diagnostic Radiology Physician	0101241822	VA

General Provider Information

NPI Number	:	1073584900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW JACKSON SELLERS MD

Provider Business Mailing Address
First Line	:	4040 E CAMELBACK RD STE 250
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-8350
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4473 N SADDLE DR
Second Line	:
City	:	BEVERLY HILLS
State	:	FL
Zip	:	34465-4855
Country	:	US
Telephone Number	:	855-687-7237
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	09/16/2025

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