Mccormick, Kelly R
Mccormick, Kelly R is an sole proprietor health care provider with primary practice located at 1600 State St , Salem OR 97301-4257. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Mccormick, Kelly R can be contacted via phone (503) 540-6300.Contact Information
Primary practice address
1600 State St
Salem OR 97301-4257
Phone: (503) 540-6300
Fax: (503) 540-6404
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | MT189201 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | MD157529 | Oregon |
Profile Details
| NPI number | 1629236229 |
|---|---|
| LBN Legal business name | Mccormick, Kelly R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 30th, 2008 |
| Last updated | Jun 10th, 2019 - about 6 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 | 1629236229 | NPPES |
| Oregon | MEDICAID | 500647558 |
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