Provider Demographics
NPI:1891953956
Name:SELLNER, THOMAS S (DO)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:S
Last Name:SELLNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ROPER CORNERS CIR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4833
Mailing Address - Country:US
Mailing Address - Phone:864-234-7815
Mailing Address - Fax:864-234-7846
Practice Address - Street 1:2 ROPER CORNERS CIR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4833
Practice Address - Country:US
Practice Address - Phone:864-234-7815
Practice Address - Fax:864-234-7846
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1467207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC014674Medicaid