Kelly, William Kevin

Kelly, William Kevin is an individual health care provider with primary practice located at 925 Chestnut St Suite 320A, Philadelphia PA 19107-4216. He recently has only one registered license in Allopathic & Osteopathic Physicians / Medical Oncology, which is considered as his primary health care specialty. Kelly, William Kevin can be contacted via phone (215) 995-8874.

Contact Information

Primary practice address
925 Chestnut St Suite 320A Philadelphia PA 19107-4216
Fax: (215) 955-2340
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X 043422 Connecticut
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X OS006196L Pennsylvania

Profile Details

NPI number 1013905512
LBN Legal business name Kelly, William Kevin
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2005
Last updated May 31st, 2011 - about 15 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 1013905512 NPPES
Pennsylvania MEDICAID 102474035
Pennsylvania MEDICAID 001434224
Pennsylvania MEDICAID 0232017

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