Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 40226 | TN |
N | 204F00000X | Transplant Surgeon | A83773 | CA |
NPI | 1427083211 |
---|---|
Provider Name | Dr. Burnett S Kelly |
First Address | Nashville, TN 37205-3230 |
Second Address | Nashville, TN 37232-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A837730 | MEDICAL (01) | CA |
40226 | MEDICAL (01) | TN |
H57704 | (02) | CA |