Individual
ROY A KELLY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
9001 SUMMA AVENUE, BATON ROUGE, LA 70809-3726
(225) 761-5259
Mailing address
1514 JEFFERSON HIGHWAY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
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
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