Deatrice L Kellogg Md

LBN: Deatrice L Kellogg Md
Deatrice L Kellogg Md is an health care organization with primary practice located at 2661 N Illinois St Pmb 309, Swansea IL 62226-2316. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as the primary health care specialty. Deatrice L Kellogg Md can be contacted via phone (618) 257-2029, or through Kellogg, Deatrice Lumae via phone (618) 257-2029.

Contact Information

Primary practice address
2661 N Illinois St Pmb 309 Swansea IL 62226-2316
Phone: (618) 257-2029
Fax: (618) 235-5371
Website:
Map and Directions
Authorized official contact:
Name: Kellogg, Deatrice Lumae Doctor of Medicine (MD)
Phone: (618) 257-2029

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 036097679 Illinois

Profile Details

NPI number 1023058484
LBN Legal business name Deatrice L Kellogg Md
DBA Doing business as
Authorized official Kellogg, Deatrice Lumae Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 7th, 2006
Last updated Sep 17th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023058484 NPPES
Other DE5033 RR MEDICARE
MEDICAID 493905552 RR MEDICARE

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