Kellum, Roy Bradley
Kellum, Roy Bradley is an individual health care provider with primary practice located at 104 Burney Dr , Flowood MS 39232-6621. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Kellum, Roy Bradley can be contacted via phone (601) 987-8200.Contact Information
Primary practice address
104 Burney Dr
Flowood MS 39232-6621
Phone: (601) 987-8200
Fax: (601) 987-8211
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 22081 | Mississippi |
Profile Details
| NPI number | 1124228754 |
|---|---|
| LBN Legal business name | Kellum, Roy Bradley |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 22nd, 2007 |
| Last updated | Sep 16th, 2019 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124228754 | NPPES |
| Mississippi | MEDICAID | 00753273 |
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