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
Phone: (479) 274-5100
Fax: (479) 274-5179
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487673216 | NPPES |
| Other | 020009996 | RR MEDICARE | |
| MEDICAID | 105887001 | RR MEDICARE |
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