Courtney Kelly, DMD is a
Student In An Organized Health Care Education/training Program based in Jbsa Lackland, Texas. Courtney Kelly is licensed to practice in * (Not Available) (license number ) and her current practice location is
1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, Texas. She can be reached at her office (for appointments etc.) via phone at
(609) 230-3674.
NPI number for Courtney Kelly is 1235759077 and her current mailing address is 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, Texas. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1235759077.
Healthcare Provider's Profile
| Full Name | Courtney Kelly |
|---|
| Gender | Female |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1235759077
- Provider Enumeration Date: 04/22/2020
- Last Update Date: 08/03/2023
Medical Identifiers
Medical identifiers for Courtney Kelly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1235759077 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | 11839022-9922 (Utah) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Courtney Kelly is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Courtney Kelly, DMD
1100 Wilford Hall Loop Bldg 4554,
Jbsa Lackland, TX 78236-5638
Ph: (210) 292-0680 | Courtney Kelly, DMD
1100 Wilford Hall Loop Bldg 4554,
Jbsa Lackland, TX 78236-5638
Ph: (609) 230-3674 |
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