Provider Demographics
NPI:1346399284
Name:SELBY, ROBERT E (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:SELBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4280 N CAMPBELL AVE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-6585
Mailing Address - Country:US
Mailing Address - Phone:520-529-2775
Mailing Address - Fax:
Practice Address - Street 1:4280 N CAMPBELL AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-6585
Practice Address - Country:US
Practice Address - Phone:520-529-2775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12716207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology