Kelly, Timothy G
Kelly, Timothy G is an sole proprietor health care provider with primary practice located at 1915 Tradd Ct , Wilmington NC 28401-6638. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Kelly, Timothy G can be contacted via phone (910) 762-0057.Contact Information
Primary practice address
1915 Tradd Ct
Wilmington NC 28401-6638
Phone: (910) 762-0057
Fax: (910) 762-0336
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 33074 | North Carolina |
Profile Details
| NPI number | 1497758825 |
|---|---|
| LBN Legal business name | Kelly, Timothy G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 31st, 2005 |
| Last updated | Oct 18th, 2013 - about 12 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 | 1497758825 | NPPES |
| North Carolina | Other | 0210J | BCBS |
| North Carolina | MEDICAID | 890210J | BCBS |
| North Carolina | Other | 0838871 | BCBS |
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