Individual
SCOTT EVAN SELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
103 RIDGEWAY ST, HOT SPRINGS, AR 71901-7102
(501) 321-2473
Mailing address
103 RIDGEWAY ST, HOT SPRINGS, AR 71901-7102
(501) 321-2473
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2286
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102427722
—
AR
01
—
49282G846
GROUP MEMBER PTAN
AR
Enumeration date
04/13/2006
Last updated
05/26/2011
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