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Individual
DR. BRIAN D KELLY
Active
Individual
DR. BRIAN D KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
258848
MA
208000000X
Pediatrics Physician
50745
AZ
2080S0010X
Pediatric Sports Medicine Physician
Primary
50745
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040502
—
AZ
Enumeration date
04/20/2010
Last updated
01/11/2023
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