Kelley, Ralph
Kelley, Ralph is an sole proprietor health care provider with primary practice located at 314 E Main St , Portageville MO 63873-1616. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adult Medicine, which is considered as his primary health care specialty. Kelley, Ralph can be contacted via phone (573) 379-3777.Contact Information
Primary practice address
314 E Main St
Portageville MO 63873-1616
Phone: (573) 379-3777
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adult Medicine | 207QA0505X | 31361 | Missouri |
Profile Details
| NPI number | 1669589677 |
|---|---|
| LBN Legal business name | Kelley, Ralph |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 24th, 2006 |
| Last updated | Dec 20th, 2016 - about 8 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 | 1669589677 | NPPES |
| Missouri | MEDICAID | 241143213 |
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