| Richard A Kelly Md, Pa | |
|
210 Goodman Rd E Southaven MS 38671-9520 | |
| (662) 349-2251 | |
| Not Available |
| Full Name | Richard A Kelly Md, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 210 Goodman Rd E, Southaven, Mississippi |
| Authorized Official Name and Position | Richard Allen Kelly (PRESIDENT) |
| Authorized Official Contact | 6623492251 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard A Kelly Md, Pa 210 Goodman Rd E Southaven MS 38671-9520 Ph: (662) 349-2251 | Richard A Kelly Md, Pa 210 Goodman Rd E Southaven MS 38671-9520 Ph: (662) 349-2251 |
| NPI Number | 1467633651 |
|---|---|
| Provider Enumeration Date | 11/16/2007 |
| Last Update Date | 11/16/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467633651 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MS11375 (Mississippi) | Primary |
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