Kelly, Gregory Thomas

Kelly, Gregory Thomas is an individual health care provider with primary practice located at 200 Hawkins Dr , Iowa City IA 52242-1009. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Kelly, Gregory Thomas can be contacted via phone (319) 356-2920.

Contact Information

Primary practice address
200 Hawkins Dr Iowa City IA 52242-1009
Phone: (319) 356-2920
Fax: (319) 384-6389
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 000645 Iowa

Profile Details

NPI number 1558359414
LBN Legal business name Kelly, Gregory Thomas
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2005
Last updated Dec 11th, 2007 - about 19 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 1558359414 NPPES
Iowa Other 46091 WELLMARK BCBS

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