Basic Information
| Provider Information | |||||||||
| NPI: | 1912536145 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHRISTOPHER R. SELLARS, DO, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4989 PEACHTREE PKWY STE 120 | ||||||||
| Address2: | |||||||||
| City: | PEACHTREE CORNERS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300922589 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7707136480 | ||||||||
| FaxNumber: | 6788689519 | ||||||||
| Practice Location | |||||||||
| Address1: | 4989 PEACHTREE PKWY STE 120 | ||||||||
| Address2: | |||||||||
| City: | PEACHTREE CORNERS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300922589 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7707136480 | ||||||||
| FaxNumber: | 6788689519 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2020 | ||||||||
| LastUpdateDate: | 04/08/2020 | ||||||||
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| AuthorizedOfficialLastName: | SELLARS | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
| AuthorizedOfficialMiddleName: | ROBERT | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5165247716 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | DO | ||||||||
| NPICertificationDate: | 04/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2081S0010X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Sports Medicine |
No ID Information.