Bacon, Kelly

Bacon, Kelly is an individual health care provider with primary practice located at 1301 E Lincoln Rd , Idabel OK 74745-7300. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Bacon, Kelly can be contacted via phone (580) 286-7623.

Contact Information

Primary practice address
1301 E Lincoln Rd Idabel OK 74745-7300
Phone: (580) 286-7623
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant 367H00000X R0071221 Oklahoma
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R0071221 Oklahoma

Profile Details

NPI number 1700844313
LBN Legal business name Bacon, Kelly
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Oct 26th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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