# DR. BRIAN D KELLY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1053637736
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | 258848 | MA | — |
| 208000000X | Pediatrics Physician | 50745 | AZ | — |
| 2080S0010X | Pediatric Sports Medicine Physician | 50745 | AZ | Yes |

## Other

- **Enumeration date:** 04/20/2010
- **Last updated:** 01/11/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 040502 | — | AZ |