Robert E. Kelly JR.
Pediatric Surgery
601 Childrens Ln
Norfolk
, Virginia 23507-1910
Robert E. Kelly JR.
Pediatric Surgery
601 Childrens Ln
Norfolk
, Virginia 23507-1910
(757) 668-8860
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About
Features
Specialties
- Pediatric Surgery
Languages spoken
- English
Location
First Address
- Robert E. Kelly JR.
- Po Box 741593 Childrens Surgical Specialty Group Inc
- Atlanta, GA
- Zip : 30374-1593
- Fax : (757) 668-8860
- Phone : (757) 668-7703
Second Address
- Robert E. Kelly JR.
- 601 Childrens Ln
- Norfolk, VA
- Zip : 23507-1910
- Fax : (757) 668-8860
- Phone : (757) 668-7703
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0120X | Pediatric Surgery | 0101050898 | VA |
National Provider Identifier
| NPI | 1396752838 |
|---|---|
| Provider Name | Robert E. Kelly JR. |
| First Address | Atlanta, GA 30374-1593 |
| Second Address | Norfolk, VA 23507-1910 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/08/2006 |
| Last Update Date | 26/12/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 006732861 | (05) | VA |
| 15404 | OPTIMA/SENTARA HEALTH (01) | VA |
| 265055 | ANTHEM BCBS (01) | VA |
| 311610834 | NC HEALTH CHOICE (01) | VA |
| 3116108340002E | CIGNA (01) | VA |
| 321883 | ALLIANCE/MDIPA (01) | VA |
| 321883 | MAMSI/OPTIMUM CHOICE (01) | VA |
| 4480859 | AETNA (01) | VA |
| 8906998 | (05) | NC |
| 8906998 | NORTH CAROLINA MEDICAID (01) | VA |
| F78605 | (02) | VA |
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.