Organization
JEFFREY W. SELBY MD PSC
Active
Other names
The Lung Centre
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY W SELBY MD (OWNER PRESIDENT)
(812) 853-5864
Entity
Organization
Contact information
Practice address
10288 W STATE ROUTE 66, NEWBURGH, IN 47630-7952
(812) 853-5864
(812) 853-5610
Mailing address
PO BOX 249, NEWBURGH, IN 47629-0249
(812) 853-5864
(812) 853-5610
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
01027862A
IN
207RP1001X
Pulmonary Disease Physician
Primary
35712
KY
363LA2100X
Acute Care Nurse Practitioner
3005907
KY
363LA2100X
Acute Care Nurse Practitioner
71002793A
IN
363LA2100X
Acute Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000307442
ANTHEM
IN
05
—
200879610
—
IN
05
—
64754484
—
KY
05
—
7100026680
—
KY
Enumeration date
03/02/2007
Last updated
08/31/2011
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