Mr. Kelly Roger Hersey
Neonatal-Perinatal Doctor
2500 N State St
Jackson
, Mississippi 39216-4500
Mr. Kelly Roger Hersey
Neonatal-Perinatal Doctor
2500 N State St
Jackson
, Mississippi 39216-4500
(601) 815-7100
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About
Features
Specialties
- Neonatal-Perinatal Doctor
Languages spoken
- English
Location
First Address
- Mr. Kelly Roger Hersey
- 2500 N State St
- Jackson, MS
- Zip : 39216-4500
- Phone : (601) 815-7100
Second Address
- Mr. Kelly Roger Hersey
- 2500 N State St
- Jackson, MS
- Zip : 39216-4500
- Phone : (601) 815-7100
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080N0001X | Neonatal-Perinatal Doctor | 15107 | MS |
National Provider Identifier
| NPI | 1083641823 |
|---|---|
| Provider Name | Mr. Kelly Roger Hersey |
| First Address | Jackson, MS 39216-4500 |
| Second Address | Jackson, MS 39216-4500 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/06/2006 |
| Last Update Date | 27/06/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 03439561 | (05) | MS |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.