Individual
DR. CRYSTAL DAWN SELUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
105 W STONE DR STE 4D, KINGSPORT, TN 37660-3365
(423) 392-6299
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2066
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
4167
IA
207Y00000X
Otolaryngology Physician
804
NE
207Y00000X
Otolaryngology Physician
Primary
DO3225
TN
207YS0123X
Facial Plastic Surgery Physician
5101016973
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025795400
—
NE
05
—
1568689420
—
IA
05
—
47068731799
—
NE
Enumeration date
04/19/2007
Last updated
07/21/2022
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