Individual
DR. AYESHA JONE' KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 SPOTSWOOD DR, LEXINGTON, VA 24450-2454
(540) 463-7108
(540) 462-2923
Mailing address
100 SPOTSWOOD DR, LEXINGTON, VA 24450-2454
(540) 463-7108
(540) 462-2923
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101-256123
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VVE294A
MEDICARE PTAN
VA
Enumeration date
04/21/2009
Last updated
12/08/2020
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