Kelly, Michael John
Kelly, Michael John is an individual health care provider with primary practice located at 9040 Jackson Ave , Tacoma WA 98431-1303. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kelly, Michael John can be contacted via phone (253) 982-7084.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 26546 | Washington |
Profile Details
| NPI number | 1093785586 |
|---|---|
| LBN Legal business name | Kelly, Michael John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 25th, 2006 |
| Last updated | Mar 13th, 2019 - about 5 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 | 1093785586 | NPPES |
| Other | 930712715 | TAX ID# |
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