Kelly, Johnson H
Kelly, Johnson H is an individual health care provider with primary practice located at 201 E Grover St , Shelby NC 28150-3917. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Urology, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Urology is his primary health care specialty. Kelly, Johnson H can be contacted via phone (980) 487-4721.Contact Information
Primary practice address
201 E Grover St
Shelby NC 28150-3917
Phone: (980) 487-4721
Fax: (980) 487-3942
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 23578 | North Carolina |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 23578 | North Carolina |
Profile Details
| NPI number | 1043223480 |
|---|---|
| LBN Legal business name | Kelly, Johnson H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 15th, 2006 |
| Last updated | Feb 10th, 2011 - about 13 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 | 1043223480 | NPPES |
| North Carolina | Other | 48217 | BCBS ID |
| North Carolina | MEDICAID | 8948217 | BCBS ID |
| North Carolina | Other | 230126 | BCBS ID |
| North Carolina | Other | 23578 | BCBS ID |
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