Hersey, Kelly Roger
Hersey, Kelly Roger is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as his primary health care specialty. Hersey, Kelly Roger can be contacted via phone (601) 815-7100.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | 15107 | Mississippi |
Profile Details
| NPI number | 1083641823 |
|---|---|
| LBN Legal business name | Hersey, Kelly Roger |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 27th, 2006 |
| Last updated | Jun 27th, 2012 - about 12 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 | 1083641823 | NPPES |
| Mississippi | MEDICAID | 03439561 |
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