Kelly, Thomas C

Kelly, Thomas C is an individual health care provider with primary practice located at 7001 Rogers Ave , Fort Smith AR 72903-4073. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Kelly, Thomas C can be contacted via phone (479) 274-5100.

Contact Information

Primary practice address
7001 Rogers Ave Fort Smith AR 72903-4073
Fax: (479) 274-5179
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X R-3264 Arkansas

Profile Details

NPI number 1487673216
LBN Legal business name Kelly, Thomas C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated Aug 28th, 2015 - about 9 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 1487673216 NPPES
Other 020009996 RR MEDICARE
MEDICAID 105887001 RR MEDICARE

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