Individual
LAWRENCE J KELLY
Active
Individual
LAWRENCE J KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
27172
AZ
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
35083
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124014758
AHCCCS
AZ
01
—
2036792
UNITED HEALTHCARE
AZ
01
—
2Z1651
HEALTHNET
AZ
05
—
514829
—
AZ
01
—
5920416
AETNA
AZ
01
—
P00188666
RAILROAD MEDICARE
AZ
01
—
P0836100
BCBS OUT OF AREA
AZ
Enumeration date
09/20/2005
Last updated
06/06/2016
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