Kelly, Roderick

Kelly, Roderick is an individual health care provider with primary practice located at 1585 3Rd St , Fort Polk LA 71459-5102. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Kelly, Roderick can be contacted via phone (337) 531-3011.

Contact Information

Primary practice address
1585 3Rd St Fort Polk LA 71459-5102
Phone: (337) 531-3011
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA02232 Texas
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA200615 Louisiana

Profile Details

NPI number 1275637472
LBN Legal business name Kelly, Roderick
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 11th, 2006
Last updated Jun 2nd, 2022 - about 2 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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