Individual
STEPHEN B. KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13921 N MERIDIAN AVE STE 100, OKLAHOMA CITY, OK 73134-1106
(405) 752-9600
(405) 752-9650
Mailing address
PO BOX 268938, OKLAHOMA CITY, OK 73126-8938
(405) 752-9600
(405) 752-9650
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21242
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100066450A
—
OK
01
—
21242
STATE MD LICENSE
OK
Enumeration date
06/02/2006
Last updated
04/19/2022
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