Kelly, Wayne

Kelly, Wayne is an individual health care provider with primary practice located at 855 Mankato Ave , Winona MN 55987-4868. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kelly, Wayne can be contacted via phone (507) 454-5050.

Contact Information

Primary practice address
855 Mankato Ave Winona MN 55987-4868
Phone: (507) 454-5050
Fax: (507) 454-5102
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 27612 Minnesota
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 41795 Wisconsin

Profile Details

NPI number 1831153972
LBN Legal business name Kelly, Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 2006
Last updated Jan 27th, 2012 - about 13 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1831153972 NPPES
Minnesota MEDICAID 503567800

Popular Providers