Twila R Sellers

Individual provider Active NPI Specialist · Hiawassee, GA

NPI 1992914220 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1992914220
Entity type
Individual (NPI type 1)
Primary specialty
Specialist 174400000X
License
001289 (GA)
Practice address
101 S Main St
Ste 5
Hiawassee, GA 30546-3249
Phone
(706) 896-2872
Fax
(706) 896-2873
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
001289GAMDSpecialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 001289 GA Yes

Addresses

Primary practice location

101 S Main St
Ste 5
Hiawassee, GA 30546-3249

Mailing address

101 S Main St
Ste 5
Hiawassee, GA 30546
Phone (706) 896-2872

Other identifiers

IdentifierTypeStateIssuer
7703186MedicaidNC

Other providers in Hiawassee, GA

All providers in Hiawassee, GA · Specialist in Georgia

Sources for this page

Verify at the official NPI Registry.