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Organization
WILLIAM S. KELLY MD PA
Active
Organization
WILLIAM S. KELLY MD PA
Active
Other names
Kernersville Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOANELLE V KELLY (OFFICE MANAGER)
(336) 993-1618
Entity
Organization
Contact information
Practice address
420 W MOUNTAIN ST, KERNERSVILLE, NC 27284-2534
(336) 993-1618
(336) 993-5512
Mailing address
420 W MOUNTAIN ST, KERNERSVILLE, NC 27284-2534
(336) 993-1618
(336) 993-5512
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40743
NC
207QG0300X
Geriatric Medicine (Family Medicine) Physician
40743
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080107394
RR MEDICARE
NC
05
—
890293K
—
NC
Enumeration date
04/10/2006
Last updated
10/24/2013
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