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Individual

WILLIAM KEVIN KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
925 CHESTNUT ST, SUITE 320A, PHILADELPHIA, PA 19107-4216
(215) 995-8874
(215) 955-2340
Mailing address
925 CHESTNUT ST, SUITE 320A, PHILADELPHIA, PA 19107-4216
(215) 995-8874
(215) 955-2340

Taxonomy

Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
043422
CT
207RX0202X
Medical Oncology Physician
Primary
OS006196L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001434224
CT
05
0232017
NJ
05
102474035
PA
Enumeration date
10/10/2005
Last updated
05/31/2011
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