Kelly, Robert B

Kelly, Robert B is an individual health care provider with primary practice located at 665 Winter St Se , Salem OR 97301-3919. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Kelly, Robert B can be contacted via phone (503) 561-5634.

Contact Information

Primary practice address
665 Winter St Se Salem OR 97301-3919
Phone: (503) 561-5634
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD 20525 Oregon

Profile Details

NPI number 1750488359
LBN Legal business name Kelly, Robert B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 19th, 2006
Last updated Dec 4th, 2007 - about 17 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 1750488359 NPPES
Other 150504 MARION POLK CHP
Other M400721 MARION POLK CHP
Other A056 MARION POLK CHP
MEDICAID 150504 MARION POLK CHP
Other G53960 MARION POLK CHP
Other G53960 MARION POLK CHP
MEDICAID 8209959 MARION POLK CHP

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