Kelly, Brian J.

Kelly, Brian J. is an individual health care provider with primary practice located at 11365 Dorsett Rd. , Maryland Heights MO 63043. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Kelly, Brian J. can be contacted via phone (314) 872-6430.

Contact Information

Primary practice address
11365 Dorsett Rd. Maryland Heights MO 63043
Phone: (314) 872-6430
Fax: (314) 872-6500
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 105182 Missouri
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 105182 Missouri
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 105182 Missouri

Profile Details

NPI number 1275550717
LBN Legal business name Kelly, Brian J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated Mar 26th, 2009 - about 17 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 1275550717 NPPES
Missouri MEDICAID 207674029
Missouri MEDICAID 036057823

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