Kelly, Marcus Jerome

Kelly, Marcus Jerome is an sole proprietor health care provider with primary practice located at 1805 Mead Ln , Moore OK 73170-1472. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Kelly, Marcus Jerome can be contacted via phone (405) 201-8496.

Contact Information

Primary practice address
1805 Mead Ln Moore OK 73170-1472
Phone: (405) 201-8496
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 081111886 Oklahoma

Profile Details

NPI number 1992065619
LBN Legal business name Kelly, Marcus Jerome
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 29th, 2012
Last updated May 29th, 2012 - about 14 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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