Kelley, Scott W.

Kelley, Scott W. is an individual health care provider with primary practice located at 12805 W Burleigh Rd Suite 200, Brookfield WI 53005-3111. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / Anatomic Pathology. Allopathic & Osteopathic Physicians / Dermatopathology is his primary health care specialty. Kelley, Scott W. can be contacted via phone (262) 797-6434.

Contact Information

Primary practice address
12805 W Burleigh Rd Suite 200 Brookfield WI 53005-3111
Phone: (262) 797-6434
Fax: (262) 797-6429
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatopathology 207ZD0900X 36968 Wisconsin
Allopathic & Osteopathic Physicians / Anatomic Pathology 207ZP0101X 36968 Wisconsin

Profile Details

NPI number 1700863685
LBN Legal business name Kelley, Scott W.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 30th, 2005
Last updated May 1st, 2015 - about 10 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 1700863685 NPPES
Wisconsin MEDICAID 32649200
Wisconsin MEDICAID 0540955

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