Walworth, Kelly J
Walworth, Kelly J is an individual health care provider with primary practice located at 13174 N Macarthur Blvd , Oklahoma City OK 73142-3017. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Walworth, Kelly J can be contacted via phone (405) 721-5555.Contact Information
Primary practice address
13174 N Macarthur Blvd
Oklahoma City OK 73142-3017
Phone: (405) 721-5555
Fax: (405) 470-7093
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 1460 | Oklahoma |
Profile Details
| NPI number | 1376526756 |
|---|---|
| LBN Legal business name | Walworth, Kelly J |
| Credentials | PAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 21st, 2005 |
| Last updated | Jul 21st, 2022 - about 4 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 | 1376526756 | NPPES |
| Oklahoma | Other | 1710198569 | GROUP NPI |
| Oklahoma | MEDICAID | 200265130A | GROUP NPI |
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