Ericson, Keelyn L

Ericson, Keelyn L is an individual health care provider with primary practice located at 823 Sw Mulvane St , Topeka KS 66606-1764. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Ericson, Keelyn L can be contacted via phone (785) 354-9591.

Contact Information

Primary practice address
823 Sw Mulvane St Topeka KS 66606-1764
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 04-30248 Kansas

Profile Details

NPI number 1952327553
LBN Legal business name Ericson, Keelyn L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2006
Last updated Jan 23rd, 2024 - about last year

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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Identifiers

StateTypeNumberIssuer
All States NPI 1952327553 NPPES
Kansas Other 067349 MEDICARE PTAN
Kansas MEDICAID 200383540B MEDICARE PTAN

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