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:
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Health care specialties

SpecialtyCodeLicense #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 10 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 1194727628 NPPES
South Carolina MEDICAID T47633

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