# KEVIN G. KELLY, M.D.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770887945
- **Authorized official:** KEVIN G. KELLY M.D. (OWNER)
- **Authorized official phone:** (256) 332-5901

## Contact information

- **Practice address:** 13150 HIGHWAY 43, SUITE 10, RUSSELLVILLE, AL 35653-4558
- **Practice address phone:** (256) 332-5901
- **Practice address fax:** (256) 332-6911
- **Mailing address:** 13150 HIGHWAY 43, SUITE 10, RUSSELLVILLE, AL 35653-4558
- **Mailing address phone:** (256) 332-5901
- **Mailing address fax:** (256) 332-6911

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 8497 | AL | Yes |

## Other

- **Enumeration date:** 01/03/2011
- **Last updated:** 01/03/2011