Kelly, Brian Thomas
Kelly, Brian Thomas is an individual health care provider with primary practice located at 16929 Frances St Ste 101 , Omaha NE 68130. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Allergy & Immunology. Allopathic & Osteopathic Physicians / Allergy & Immunology is his primary health care specialty. Kelly, Brian Thomas can be contacted via phone (402) 758-5125.Contact Information
Primary practice address
16929 Frances St Ste 101
Omaha NE 68130
Phone: (402) 758-5125
Fax: (531) 255-0001
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 59455 | Minnesota |
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | 55878 | Wisconsin |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 55878 | Wisconsin |
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | 59455 | Minnesota |
Profile Details
| NPI number | 1306089230 |
|---|---|
| LBN Legal business name | Kelly, Brian Thomas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 7th, 2009 |
| Last updated | Oct 2nd, 2018 - about 8 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 | 1306089230 | NPPES |
| Wisconsin | MEDICAID | 1306089230 |
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