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:
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Health care specialties

SpecialtyCodeLicense #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 11 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 1497758825 NPPES
North Carolina Other 0210J BCBS
North Carolina MEDICAID 890210J BCBS
North Carolina Other 0838871 BCBS

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