Individual
DR. CARL ARIS KELLY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2915 E TEXAS ST, BOSSIER CITY, LA 71111-3201
(318) 747-3477
(318) 747-7932
Mailing address
2915 E TEXAS ST, BOSSIER CITY, LA 71111-3201
(318) 747-3477
(318) 747-7932
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
797
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1364835
—
LA
Enumeration date
03/26/2007
Last updated
07/08/2007
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