Douglas Wayne Kelly, M.D. Valid NPI

Individual provider · Sports Medicine (Orthopaedic Surgery) Physician · Phoenix, AZ

NPI

1104924158

Type

Individual (Type 1)

Primary specialty

Sports Medicine (Orthopaedic Surgery) Physician (Orthopaedic Surgery)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207XX0005X

License number

12896 (AZ)

Sex

Male

Sole proprietor

Yes

Enumerated

2006-09-20

Last updated

2007-07-08