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Individual

DR. MICHAEL TIMOTHY KELLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1166 DUBLIN RD, SUITE 400, COLUMBUS, OH 43215-1030
(614) 544-4605
Mailing address
8E BROAD ST 501, COLUMBUS, OH 43215-3435
(614) 486-7774

Taxonomy

Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
35048006K
OH
2083X0100X
Occupational Medicine Physician
39072
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0672811
OH
Enumeration date
12/16/2005
Last updated
11/30/2016
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