Kelly, Timothy J
Kelly, Timothy J is an sole proprietor health care provider with primary practice located at 200 S Herlong Ave Suite A, Rock Hill SC 29732-3399. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Kelly, Timothy J can be contacted via phone (803) 328-1864.Contact Information
Primary practice address
200 S Herlong Ave Suite A
Rock Hill SC 29732-3399
Phone: (803) 328-1864
Fax: (803) 328-1865
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 30274 | South Carolina |
Profile Details
| NPI number | 1689731085 |
|---|---|
| LBN Legal business name | Kelly, Timothy J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 3rd, 2007 |
| Last updated | Apr 26th, 2021 - about 3 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 | 1689731085 | NPPES |
| Other | 1506232 | COVENTRY | |
| MEDICAID | 302746 | COVENTRY | |
| Other | AA21828218 | COVENTRY | |
| Other | P01505878 | COVENTRY |
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