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NPI Code Detail

MEDICARE: DR. CALEB THOMAS SELBY PHARMD

MEDICARE:  DR. CALEB THOMAS SELBY  PHARMD
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
1183500000XPharmacist052646NY
2183500000XPharmacist42241TN

General Provider Information

NPI Number : 1770805095
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CALEB THOMAS SELBY PHARMD
Provider Business Mailing Address
First Line : 3355 AUTUMN WOOD DR
Second Line :
City : MACEDON
State : NY
Zip : 14502-8752
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 418 S GAY ST STE 104
Second Line :
City : KNOXVILLE
State : TN
Zip : 37902-1134
Country : US
Telephone Number : 865-692-1603
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2010
Last Update Date : 11/13/2020

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Directions to “ DR. CALEB THOMAS SELBY PHARMD” Practice Location

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