Kelly, Jacob Patrick
Kelly, Jacob Patrick is an individual health care provider with primary practice located at 3841 Piper St Ste T100 , Anchorage AK 99508-4674. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Advanced Heart Failure and Transplant Cardiology. Allopathic & Osteopathic Physicians / Advanced Heart Failure and Transplant Cardiology is his primary health care specialty. Kelly, Jacob Patrick can be contacted via phone (907) 561-3211.Contact Information
Primary practice address
3841 Piper St Ste T100
Anchorage AK 99508-4674
Phone: (907) 561-3211
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | N5767 | Texas |
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 2012-01069 | North Carolina |
Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 119045 | Alaska |
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 2012-01069 | North Carolina |
Allopathic & Osteopathic Physicians / Advanced Heart Failure and Transplant Cardiology | 207RA0001X | 119045 | Alaska |
Profile Details
NPI number | 1851551949 |
---|---|
LBN Legal business name | Kelly, Jacob Patrick |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 11th, 2008 |
Last updated | Feb 12th, 2019 - about 5 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 | 1851551949 | NPPES |
Alaska | MEDICAID | 1668479 | |
Alaska | MEDICAID | 1851551949 |
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