Kelly, Kevin J

Kelly, Kevin J is an individual health care provider with primary practice located at 9000 W Wisconsin Ave Pediatric Allergy/Immunology, Milwaukee WI 53226-4874. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Allergy/Immunology, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatric Allergy/Immunology is his primary health care specialty. Kelly, Kevin J can be contacted via phone (414) 607-5280.

Contact Information

Primary practice address
9000 W Wisconsin Ave Pediatric Allergy/Immunology Milwaukee WI 53226-4874
Phone: (414) 607-5280
Fax: (414) 266-6849
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Allergy/Immunology 2080P0201X 22420 Wisconsin
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2005026718 Missouri

Profile Details

NPI number 1396703450
LBN Legal business name Kelly, Kevin J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2006
Last updated Dec 8th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396703450 NPPES
Wisconsin MEDICAID 1396703450
Wisconsin MEDICAID 207550708

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