Kelly, Larry W
Kelly, Larry W is an individual health care provider with primary practice located at 64 Business Center Dr , Pawleys Island SC 29585-7963. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Kelly, Larry W can be contacted via phone (843) 314-1314.Contact Information
Primary practice address
64 Business Center Dr
Pawleys Island SC 29585-7963
Phone: (843) 314-1314
Fax: (843) 314-1307
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 20643 | South Carolina |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 20643 | South Carolina |
Profile Details
| NPI number | 1194727628 |
|---|---|
| LBN Legal business name | Kelly, Larry W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 15th, 2005 |
| Last updated | Apr 21st, 2015 - about 9 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 | 1194727628 | NPPES |
| South Carolina | MEDICAID | T47633 |
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