Oggero, Kelly S

Oggero, Kelly S is an sole proprietor health care provider with primary practice located at 130 W Ravine Rd Ste 3A , Kingsport TN 37660-3841. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Oggero, Kelly S can be contacted via phone (423) 245-6101.

Contact Information

Primary practice address
130 W Ravine Rd Ste 3A Kingsport TN 37660-3841
Phone: (423) 245-6101
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X H0700 Texas
Allopathic & Osteopathic Physicians / Surgery 208600000X 50412 Tennessee

Profile Details

NPI number 1417990730
LBN Legal business name Oggero, Kelly S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2006
Last updated Oct 9th, 2023 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417990730 NPPES
Texas MEDICAID P000G86F4

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