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Individual

DR. BRIAN D KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-3033
(602) 933-5245
Mailing address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-3033
(602) 933-5245

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
258848
MA
208000000X
Pediatrics Physician
50745
AZ
2080S0010X
Pediatric Sports Medicine Physician
Primary
50745
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
040502
AZ
Enumeration date
04/20/2010
Last updated
01/11/2023
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