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Individual

DR. BENJAMIN MICHAEL SELPH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARM.D.

Contact information

Practice address
1826 VETERANS BLVD, DUBLIN, GA 31021-3620
(478) 272-1210
Mailing address
15104 TIPPETTVILLE RD, PINEVIEW, GA 31071-3019
(229) 624-2894

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH026683
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RPH026683
PHARMACIST LICENSE
GA
Enumeration date
07/10/2012
Last updated
07/10/2012
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