Kelley, Kevin J

Kelley, Kevin J is an individual health care provider with primary practice located at 4689 Fulton Dr Nw , Canton OH 44718-2379. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Kelley, Kevin J can be contacted via phone (330) 649-9400.

Contact Information

Primary practice address
4689 Fulton Dr Nw Canton OH 44718-2379
Phone: (330) 649-9400
Fax: (330) 649-8059
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X KE4069601 Ohio

Profile Details

NPI number 1982600979
LBN Legal business name Kelley, Kevin J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2005
Last updated Jul 27th, 2010 - about 15 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 1982600979 NPPES
Ohio MEDICAID 2313740

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