Kelley, Michael D

Kelley, Michael D is an individual health care provider with primary practice located at 3535 Southern Blvd , Kettering OH 45429-1221. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Kelley, Michael D can be contacted via phone (937) 395-6665.

Contact Information

Primary practice address
3535 Southern Blvd Kettering OH 45429-1221
Phone: (937) 395-6665
Fax: (937) 395-6668
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 50003217 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 50003217 Ohio

Profile Details

NPI number 1043284698
LBN Legal business name Kelley, Michael D
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2006
Last updated Jan 20th, 2021 - about 3 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 1043284698 NPPES
Ohio MEDICAID 0085230

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