Kelly, Ian Patrick

Kelly, Ian Patrick is an individual health care provider with primary practice located at Madigan Army Medical Center 9040 Jackson Ave , Tacoma WA 98431-4504. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Kelly, Ian Patrick can be contacted via phone (253) 968-2252.

Contact Information

Primary practice address
Madigan Army Medical Center 9040 Jackson Ave Tacoma WA 98431-4504
Phone: (253) 968-2252
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X MD61448867 Washington
Allopathic & Osteopathic Physicians / General Practice 208D00000X 30529 Nebraska
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 30529 Nebraska

Profile Details

NPI number 1912365024
LBN Legal business name Kelly, Ian Patrick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 3rd, 2016
Last updated May 30th, 2024 - about 2 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 1912365024 NPPES
Washington MEDICAID 2258356

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