Moss, Kelvin Jerry
Moss, Kelvin Jerry is an sole proprietor health care provider with primary practice located at 1200 Memorial Dr , Dalton GA 30720-2529. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Moss, Kelvin Jerry can be contacted via phone (706) 217-2207.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | GA 054634 | Georgia |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 054634 | Georgia |
Profile Details
| NPI number | 1275640526 |
|---|---|
| LBN Legal business name | Moss, Kelvin Jerry |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 24th, 2006 |
| Last updated | Mar 17th, 2018 - about 7 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 | 1275640526 | NPPES |
| Georgia | MEDICAID | 839374814G |
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