Individual
TIMOTHY RICHARD KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
510 AZALEA DR STE 200, OXFORD, MS 38655-6903
(662) 236-6696
Mailing address
438 COUNTY ROAD 471, WATER VALLEY, MS 38965-3778
(662) 281-0945
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
17172
MS
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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