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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 7 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 1306089230 NPPES
Wisconsin MEDICAID 1306089230

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