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:
Health care specialties
| Specialty | Code | License # | 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 last year |
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 | 1114943990 | NPPES |
| Louisiana | MEDICAID | 1653071 |
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