David J Kelly, MD Valid NPI

Individual provider · Family Medicine Physician · Eagle, ID

NPI

1194862417

Type

Individual (Type 1)

Primary specialty

Family Medicine Physician (Family Medicine)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207Q00000X

License number

M-17694 (ID)

Sex

Male

Sole proprietor

No

Enumerated

2007-01-30

Last updated

2024-04-04