Individual
SAMUEL K KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2327 NEW HOLT RD, PADUCAH, KY 42001-7404
(270) 534-5128
(270) 477-0007
Mailing address
5050 VILLAGE SQUARE DR STE B, PADUCAH, KY 42001-7552
(270) 534-5128
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
59615
KY
2084P0804X
Child & Adolescent Psychiatry Physician
72427
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154368199
NPI
MA
Enumeration date
05/31/2006
Last updated
11/03/2025
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