Kelley, Marty J

Kelley, Marty J is an individual health care provider with primary practice located at 2916 Hamilton Blvd , Sioux City IA 51104-2429. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Kelley, Marty J can be contacted via phone (712) 255-1621.

Contact Information

Primary practice address
2916 Hamilton Blvd Sioux City IA 51104-2429
Phone: (712) 255-1621
Fax: (712) 255-1389
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 00763 Iowa

Profile Details

NPI number 1215924253
LBN Legal business name Kelley, Marty J
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2005
Last updated Apr 28th, 2008 - about 16 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 1215924253 NPPES
Iowa MEDICAID 0435834
Iowa MEDICAID 0289124
Iowa MEDICAID 10025293700

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