O'Kelly, Amanda Gayle

O'Kelly, Amanda Gayle is an individual health care provider with primary practice located at 727 Se Main St Suite 320, Simpsonville SC 29681-3247. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. O'Kelly, Amanda Gayle can be contacted via phone (864) 454-6440.

Contact Information

Primary practice address
727 Se Main St Suite 320 Simpsonville SC 29681-3247
Phone: (864) 454-6440
Fax: (864) 454-6445
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 207RA0000X 29908 South Carolina
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 29908 South Carolina
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 29908 South Carolina

Profile Details

NPI number 1578767323
LBN Legal business name O'Kelly, Amanda Gayle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2007
Last updated Mar 23rd, 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 1578767323 NPPES
South Carolina MEDICAID 299082

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