Individual
EVAN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
320 EAST MAIN ST, CROSBY, MN 56441
(218) 546-7000
(218) 546-4400
Mailing address
320 EAST MAIN ST, CROSBY, MN 56441
(218) 546-7000
(218) 546-4400
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
56579
KY
208600000X
Surgery Physician
Primary
69041
MN
390200000X
Student in an Organized Health Care Education/Training Program
TP 00013351
CO
Other
Enumeration date
06/17/2016
Last updated
11/06/2025
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