Kelly, Lawrence Bennett
Kelly, Lawrence Bennett is an sole proprietor health care provider with primary practice located at 4825 Maccorkle Ave Sw Ste C , South Charleston WV 25309-1365. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Kelly, Lawrence Bennett can be contacted via phone (304) 343-1022.Contact Information
Primary practice address
4825 Maccorkle Ave Sw Ste C
South Charleston WV 25309-1365
Phone: (304) 343-1022
Fax: (304) 343-1025
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 12306 | West Virginia |
Profile Details
| NPI number | 1629031901 |
|---|---|
| LBN Legal business name | Kelly, Lawrence Bennett |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 8th, 2006 |
| Last updated | Feb 2nd, 2024 - about 10 months 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 | 1629031901 | NPPES |
| West Virginia | Other | 001720795 | BLUE CROSS BLUE SHIELD |
| West Virginia | MEDICAID | 0114543001 | BLUE CROSS BLUE SHIELD |
| West Virginia | Other | 260047649 | BLUE CROSS BLUE SHIELD |
Popular Providers
-
Espiritu, Julian Llado
24 Maccorkle Ave Sw Suite 201, South Charleston WV 25303-1476 -
Campbell, Amos
208 7Th Ave , South Charleston WV 25303-1510 -
Townshend, Kimberly
208 7Th Ave , South Charleston WV 25303-1510 -
Doromal, Noel M.
4605 Maccorkle Ave Sw , South Charleston WV 25309-1311 -
Wazir, Badshah J.
428 Division St , South Charleston WV 25309-1469 -
Ghannam, Mouwafak
4501 Maccorkle Ave Sw Suite 401, South Charleston WV 25309-1444 -
Hill, Andrea
4607 Maccorkle Ave Sw Suite 201, South Charleston WV 25309-1364 -
Warren, Kimberly Dawn
4834 Maccorkle Ave Sw , South Charleston WV 25309-1340