Haworth, Kellie Brook
Haworth, Kellie Brook is an individual health care provider with primary practice located at 262 Danny Thomas Pl , Memphis TN 38105-3678. She recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology is her primary health care specialty. Haworth, Kellie Brook can be contacted via phone (901) 595-4925.Contact Information
Primary practice address
262 Danny Thomas Pl
Memphis TN 38105-3678
Phone: (901) 595-4925
Fax: (901) 595-9005
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 35.098813 | Ohio |
| Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 2080P0204X | 35.098813 | Ohio |
| Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology | 2080P0207X | 35.098813 | Ohio |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology | 2080P0207X | 56657 | Tennessee |
Profile Details
| NPI number | 1902006497 |
|---|---|
| LBN Legal business name | Haworth, Kellie Brook |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 23rd, 2007 |
| Last updated | Nov 15th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902006497 | NPPES |
| Ohio | MEDICAID | 0123305 |
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