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Individual

MS. ANGELA SELMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
700 S TELEPHONE ROAD, MOORE, OK 73160
(405) 793-9355
Mailing address
2612 NW 152ND ST, EDMOND, OK 73013

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
17207
OK
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
17207
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100199610A
OK
Enumeration date
05/23/2006
Last updated
06/02/2010
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