Individual
DR. BRIAN THOMAS KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16929 FRANCES ST STE 101, OMAHA, NE 68130
(402) 758-5125
(531) 255-0001
Mailing address
555 N 30TH ST, OMAHA, NE 68131-2136
(531) 355-6540
(531) 355-0001
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
55878
WI
207K00000X
Allergy & Immunology Physician
Primary
59455
MN
208000000X
Pediatrics Physician
55878
WI
208000000X
Pediatrics Physician
59455
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306089230
—
WI
Enumeration date
04/07/2009
Last updated
10/02/2018
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