Kellum, Ronald Fulton

Kellum, Ronald Fulton is an individual health care provider with primary practice located at 4433 Leisure Time , Diamondhead MS 39525-3259. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kellum, Ronald Fulton can be contacted via phone (228) 586-9229.

Contact Information

Primary practice address
4433 Leisure Time Diamondhead MS 39525-3259
Phone: (228) 586-9229
Fax: (228) 586-9230
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 19011 Mississippi

Profile Details

NPI number 1679543102
LBN Legal business name Kellum, Ronald Fulton
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2006
Last updated Jan 23rd, 2014 - about 11 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 1679543102 NPPES
Mississippi Other 19011 MISSISSIPPI LICENSE

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