Individual
ROY A KELLY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
010587
LA
208800000X
Urology Physician
Primary
MD.010587
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05877708
—
MS
05
—
1336297
—
LA
01
—
340007213
RAILROAD MEDICARE
LA
Enumeration date
05/10/2006
Last updated
12/27/2011
Update your record
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