Kelly, John T

Kelly, John T is an individual health care provider with primary practice located at 1821 S Stoughton Rd , Madison WI 53716-2257. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Kelly, John T can be contacted via phone (608) 260-6000.

Contact Information

Primary practice address
1821 S Stoughton Rd Madison WI 53716-2257
Fax: (608) 260-6429
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 47350-20 Wisconsin

Profile Details

NPI number 1104874361
LBN Legal business name Kelly, John T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Jan 27th, 2021 - about 5 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 1104874361 NPPES
Wisconsin MEDICAID 1104874361
Wisconsin Other P01443027

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