Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 34400 | KY |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 34400 | KY |
NPI | 1508820846 |
---|---|
Provider Name | Dr. Jeffrey Bryan Selby |
First Address | Lexington, KY 40536-0001 |
Second Address | Lexington, KY 40536-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 05/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H62506 | (02) | KY |