Kelly, Keith Edward
Kelly, Keith Edward is an individual health care provider with primary practice located at 1920 Broadway St , Paducah KY 42001-7106. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pulmonary Disease, which is considered as his primary health care specialty. Kelly, Keith Edward can be contacted via phone (270) 442-3647.Contact Information
Primary practice address
1920 Broadway St
Paducah KY 42001-7106
Phone: (270) 442-3647
Fax: (270) 442-3777
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 39808 | Kentucky |
Profile Details
| NPI number | 1396856746 |
|---|---|
| LBN Legal business name | Kelly, Keith Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Dec 7th, 2020 - about 4 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 | 1396856746 | NPPES |
| Kentucky | Other | P00266587 | RAILROAD MEDICARE |
| Kentucky | MEDICAID | 64113657 | RAILROAD MEDICARE |
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