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Individual

DR. WILLIAM KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
941 E HUBBLE DR, MARSHFIELD, MO 65706-2538
(417) 269-1940
(417) 269-1948
Mailing address
3800 S NATIONAL AVE, #540, SPRINGFIELD, MO 65807-5209
(417) 269-1940
(417) 269-1948

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
105766
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107908
BCMO
MO
05
208663419
MO
Enumeration date
10/13/2006
Last updated
09/12/2016
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