MEDICARE: SETH JACOB SELBY PA-C

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	363AM0700X	Medical Physician Assistant	PA.0006899	CO

General Provider Information

NPI Number	:	1932733086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SETH JACOB SELBY PA-C

Provider Business Mailing Address
First Line	:	1805 SHEA CENTER DR STE 301
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80129-2277
Country	:	US
Telephone Number	:	303-814-0505
Fax Number	:	303-814-6491

Provider Business Practice Location Address
First Line	:	50 BUCK CREEK RD STE 200
Second Line	:
City	:	AVON
State	:	CO
Zip	:	81620-5428
Country	:	US
Telephone Number	:	970-926-6340
Fax Number	:	970-926-6348

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

Provider Enumeration Date	:	02/27/2020
Last Update Date	:	05/15/2026

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