| Dr Dale Marcus Selby, MD | |
|
2200 Bergquist Dr, Suite 1, Wilford Hall Medical Center, Dept Of Pathology, Lackland A F B, TX 78236-9907 | |
| (210) 292-5455 | |
| Not Available |
| Full Name | Dr Dale Marcus Selby |
|---|---|
| Gender | Male |
| Speciality | Pathology |
| Experience | 29 Years |
| Location | 2200 Bergquist Dr, Lackland A F B, Texas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922088103 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 4301079315 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Missouri Baptist Medical Center | Town and country, MO | Hospital |
| Barnes-jewish St Peters Hospital | Saint peters, MO | Hospital |
| Progress West Hospital | O fallon, MO | Hospital |
| Missouri Baptist Sullivan Hospital | Sullivan, MO | Hospital |
| Barnes Jewish Hospital | Saint louis, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Parkway Pathology Group Inc | 5496728818 | 8 |
| Entity Name | Parkway Pathology Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245206960 PECOS PAC ID: 5496728818 Enrollment ID: O20040814000088 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Dale Marcus Selby, MD 8202 Creekrun Path, San Antonio, TX 78249-3820 Ph: (210) 681-1247 | Dr Dale Marcus Selby, MD 2200 Bergquist Dr, Suite 1, Wilford Hall Medical Center, Dept Of Pathology, Lackland A F B, TX 78236-9907 Ph: (210) 292-5455 |
Dr. Lisa Karen Culton, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236 Phone: 210-292-4569 Fax: 210-292-7484 | |
Dr. Kondi Wong, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 2200 Bergquist Dr, Attn Credentials (cmc), Lackland A F B, TX 78236 Phone: 210-292-6812 |