Individual
MADISON PRICE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1400 8TH AVE, FORT WORTH, TX 76104-4110
(817) 922-4588
Mailing address
1400 8TH AVE, FORT WORTH, TX 76104-4110
(817) 922-4588
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
BP10085875
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2023
Last updated
03/28/2024
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