Individual
DR. KC KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2323 MEMORIAL AVE STE 10, LYNCHBURG, VA 24501-2652
(143) 420-0615
Mailing address
16890 FOREST RD, FOREST, VA 24551-4059
(434) 200-7210
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0116037899
VA
261QP2300X
Primary Care Clinic/Center
Primary
0102210148
VA
390200000X
Student in an Organized Health Care Education/Training Program
0116037899
VA
Other
Enumeration date
06/05/2023
Last updated
05/18/2026
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