Wilson, Kelby Jon

Wilson, Kelby Jon is an individual health care provider with primary practice located at 607 W Main St , Grangeville ID 83530-1345. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wilson, Kelby Jon can be contacted via phone (208) 983-1700.

Contact Information

Primary practice address
607 W Main St Grangeville ID 83530-1345
Phone: (208) 983-1700
Fax: (208) 983-4665
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M-14749 Idaho

Profile Details

NPI number 1164872115
LBN Legal business name Wilson, Kelby Jon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2016
Last updated Sep 30th, 2020 - about 6 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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