Ivester, Kelly J

Ivester, Kelly J is an individual health care provider with primary practice located at 1415 Tulane Ave Hc 71, New Orleans LA 70112-2600. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Ivester, Kelly J can be contacted via phone (504) 988-5800.

Contact Information

Primary practice address
1415 Tulane Ave Hc 71 New Orleans LA 70112-2600
Phone: (504) 988-5800
Fax: (504) 988-7616
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 200101 Louisiana

Profile Details

NPI number 1740263052
LBN Legal business name Ivester, Kelly J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 22nd, 2005
Last updated Aug 14th, 2007 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1740263052 NPPES
Louisiana MEDICAID 1628085

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