Kelley, Russell
Kelley, Russell is an individual health care provider with primary practice located at 2101 N Waldron St , Hutchinson KS 67502-1131. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Kelley, Russell can be contacted via phone (620) 669-2500.Contact Information
Primary practice address
2101 N Waldron St
Hutchinson KS 67502-1131
Phone: (620) 669-2500
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 04-25022 | Kansas |
Profile Details
| NPI number | 1881665727 |
|---|---|
| LBN Legal business name | Kelley, Russell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 30th, 2006 |
| Last updated | Sep 21st, 2023 - 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 | 1881665727 | NPPES |
| Kansas | MEDICAID | 100161810 A |
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