Kelly, Frederick Wayne
Kelly, Frederick Wayne is an individual health care provider with primary practice located at 1024 1St Ave , Gadsden AL 35901. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kelly, Frederick Wayne can be contacted via phone (256) 543-7406.Contact Information
Primary practice address
1024 1St Ave
Gadsden AL 35901
Phone: (256) 543-7406
Fax: (256) 543-1661
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 17437 | Alabama |
Profile Details
| NPI number | 1750327854 |
|---|---|
| LBN Legal business name | Kelly, Frederick Wayne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 20th, 2006 |
| Last updated | Sep 17th, 2018 - 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 | 1750327854 | NPPES |
| Alabama | MEDICAID | 051523084 | |
| Alabama | Other | 051523084 | |
| Alabama | Other | P00147324 |
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