Provider Demographics
NPI:1063426963
Name:SELBY, LISBETH A W (MD)
Entity type:Individual
Prefix:
First Name:LISBETH
Middle Name:A W
Last Name:SELBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2333 ALUMNI PARK PLZ
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-4012
Mailing Address - Country:US
Mailing Address - Phone:859-257-7910
Mailing Address - Fax:
Practice Address - Street 1:UK DIGESTIVE DISEASES
Practice Address - Street 2:740 S. LIMESTONE
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-323-0079
Practice Address - Fax:859-257-9287
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2012-12-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY34077207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64270820Medicaid
KY0741043Medicare PIN
E67755Medicare UPIN