Kelley, Roger Everett

Kelley, Roger Everett is an individual health care provider with primary practice located at 1541 Kings Hwy , Shreveport LA 71103-4228. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Vascular Neurology. Allopathic & Osteopathic Physicians / Vascular Neurology is his primary health care specialty. Kelley, Roger Everett can be contacted via phone (318) 626-0000.

Contact Information

Primary practice address
1541 Kings Hwy Shreveport LA 71103-4228
Phone: (318) 626-0000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 013686 Louisiana
Allopathic & Osteopathic Physicians / Vascular Neurology 2084V0102X MD.013686 Louisiana

Profile Details

NPI number 1114943990
LBN Legal business name Kelley, Roger Everett
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2006
Last updated Mar 11th, 2024 - about 6 months 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 1114943990 NPPES
Louisiana MEDICAID 1653071

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