| Sellerssportsmed Llc | |
|
1840 E Baseline Rd Ste C2 Tempe AZ 85283-1528 | |
| (480) 751-3777 | |
| (480) 751-3785 |
| Full Name | Sellerssportsmed Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1840 E Baseline Rd Ste C2, Tempe, Arizona |
| Authorized Official Name and Position | Joel S Sellers (PHYSICIAN) |
| Authorized Official Contact | 4804262667 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sellerssportsmed Llc 1840 E Baseline Rd Ste C2 Tempe AZ 85283-1528 Ph: (480) 751-3777 | Sellerssportsmed Llc 1840 E Baseline Rd Ste C2 Tempe AZ 85283-1528 Ph: (480) 751-3777 |
| NPI Number | 1003373507 |
|---|---|
| Provider Enumeration Date | 02/21/2019 |
| Last Update Date | 07/01/2019 |
| Medicare PECOS PAC ID | 9830427129 |
|---|---|
| Medicare Enrollment ID | O20190823003001 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003373507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Joel S Sellers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710958517 PECOS PAC ID: 0941285290 Enrollment ID: I20040629000993 |
| Provider Name | Thomas Edward Sellers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497217210 PECOS PAC ID: 2264801604 Enrollment ID: I20230809003171 |
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