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NPI Code Detail

MEDICARE: BENJAMIN SELANDER

MEDICARE: BENJAMIN SELANDER
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
1390200000XStudent in an Organized Health Care Education/Training Program8698OK

General Provider Information

NPI Number : 1942903695
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENJAMIN SELANDER
Provider Business Mailing Address
First Line : 7314 E 89TH PL N
Second Line :
City : OWASSO
State : OK
Zip : 74055-7996
Country : US
Telephone Number : 406-231-8880
Fax Number :
Provider Business Practice Location Address
First Line : 744 W 9TH ST
Second Line :
City : TULSA
State : OK
Zip : 74127-9907
Country : US
Telephone Number : 918-599-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2023
Last Update Date : 03/08/2026

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Directions to “ BENJAMIN SELANDER ” Practice Location

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