Individual
DR. ROY BRADLEY KELLUM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
104 BURNEY DR, FLOWOOD, MS 39232-6621
(601) 987-8200
(601) 987-8211
Mailing address
PO BOX 30594, CHARLOTTE, NC 28230-0594
(601) 987-8200
(601) 987-8211
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
22081
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00753273
—
MS
Enumeration date
07/22/2007
Last updated
09/16/2019
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