Killebrew, Larry H
Killebrew, Larry H is an individual health care provider with primary practice located at 4500 13Th St , Gulfport MS 39501-2515. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Killebrew, Larry H can be contacted via phone (228) 865-3151.Contact Information
Primary practice address
4500 13Th St
Gulfport MS 39501-2515
Phone: (228) 865-3151
Fax: (228) 867-4124
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 08371 | Mississippi |
Profile Details
| NPI number | 1265514301 |
|---|---|
| LBN Legal business name | Killebrew, Larry H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 19th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1265514301 | NPPES |
| Mississippi | MEDICAID | 00119198 |
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