Philip L Kelton Jr MD PA

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

D7112 Issued in TX

Legal business name

PHILIP L KELTON JR MD PA

Practice address

3600 Gaston Ave
Wadley Tower Suite 1054
Dallas, TX 75246-1910

Phone

(214) 826-8950

Fax

(214) 826-3434

NPI assigned

Apr 3, 2006

Last updated

Aug 20, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Philip Llewellyn Kelton Jr., MDNPI 1336335223

Title

Owner President

Phone

(214) 826-8950

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Philip Llewellyn Kelton Jr., M.D.

  • Plastic and Reconstructive Surgery Physician
  • Dallas, TX
  • NPI 1336335223
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282262400000",
    "number": "1982666434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE LB-78",
            "address_2": "WADLEY TOWER SUITE 1054",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461910",
            "telephone_number": "214-826-8950",
            "fax_number": "214-826-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE",
            "address_2": "WADLEY TOWER SUITE 1054",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461910",
            "telephone_number": "214-826-8950",
            "fax_number": "214-826-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP L KELTON JR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-03",
        "last_updated": "2010-08-20",
        "status": "A",
        "authorized_official_last_name": "KELTON",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "LLEWELLYN",
        "authorized_official_title_or_position": "OWNER  PRESIDENT",
        "authorized_official_telephone_number": "214-826-8950",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "D7112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115836201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04616699757",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin Yainthang Phen, MD
• Rawle Fabian Philbert, DDS
• Philip B. Halloran, MD
• Philip Brown, MD, PA
• Philip Kozlow, D.D.S.
• Philip M Brown MD PA
• Philip O Smith MD PA
• Alina Maria Philip
• Annie J Philip, MD
• Arun Philip, DO

• Plastic and Reconstructive Surgery Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Plastic and Reconstructive Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.