Shell, Jerry Keith
Shell, Jerry Keith is an individual health care provider with primary practice located at 2254 Olympic St , Springfield OH 45503-2737. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Shell, Jerry Keith can be contacted via phone (937) 399-8287.Contact Information
Primary practice address
2254 Olympic St
Springfield OH 45503-2737
Phone: (937) 399-8287
Fax: (937) 399-1670
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 35045125S | Ohio |
Profile Details
| NPI number | 1235132135 |
|---|---|
| LBN Legal business name | Shell, Jerry Keith |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 24th, 2005 |
| Last updated | Jul 9th, 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 | 1235132135 | NPPES |
| Ohio | MEDICAID | 0431474 |
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