Individual
THOMAS MICHAEL KELLEY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2817 ROCK MERRITT AVE, FORT BRAGG, NC 28310-7324
(910) 907-7624
Mailing address
2817 ROCK MERRIT AVE, FORT BRAGG, NC 28310-7324
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
267056
NC
208600000X
Surgery Physician
74379
GA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/25/2014
Last updated
03/13/2025
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