Provider Demographics
NPI:1881849941
Name:T DUNCAN SELLERS, ELECTROPHYSIOLOGIST
Entity Type:Organization
Organization Name:T DUNCAN SELLERS, ELECTROPHYSIOLOGIST
Other - Org Name:T DUNCAN SELLERS MD
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:DUNCAN
Authorized Official - Last Name:SELLERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-475-2794
Mailing Address - Street 1:525 N FOOTE AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-4554
Mailing Address - Country:US
Mailing Address - Phone:719-475-2794
Mailing Address - Fax:
Practice Address - Street 1:525 N FOOTE AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-4554
Practice Address - Country:US
Practice Address - Phone:719-475-2794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO33016207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01330166Medicaid
CO01330166Medicaid
COE3728Medicare PIN