Koons, Kelli Denise
Koons, Kelli Denise is an individual health care provider with primary practice located at 3315 Kethley Rd , Shawnee OK 74804-9638. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Koons, Kelli Denise can be contacted via phone (405) 273-5801.Contact Information
Primary practice address
3315 Kethley Rd
Shawnee OK 74804-9638
Phone: (405) 273-5801
Fax: (405) 878-3814
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 22002 | Oklahoma |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 22002 | Oklahoma |
Profile Details
| NPI number | 1134169295 |
|---|---|
| LBN Legal business name | Koons, Kelli Denise |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 7th, 2006 |
| Last updated | Aug 30th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134169295 | NPPES |
| Oklahoma | MEDICAID | 100103130B |
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