Individual
DR. THOMAS B. KELSO II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
902 N HOWE ST, SOUTHPORT, NC 28461-3038
(910) 457-4789
(910) 579-4589
Mailing address
902 N HOWE ST, SOUTHPORT, NC 28461-3038
(910) 457-4789
(910) 579-4589
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
120032
MO
207X00000X
Orthopaedic Surgery Physician
Primary
200300626
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204883003
—
MO
Enumeration date
02/01/2007
Last updated
12/19/2016
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