Individual
STEPHEN J KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
28419
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46-1498286
IRS TAX ID
AL
Enumeration date
04/10/2007
Last updated
08/24/2016
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