Individual
DR. KELLY MARIE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1125 MADISON ST, JEFFERSON CITY, MO 65101-5227
(573) 632-5000
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2014014696
MO
207P00000X
Emergency Medicine Physician
Primary
2021016294
MO
207P00000X
Emergency Medicine Physician
MD-44341
IA
207R00000X
Internal Medicine Physician
2021016294
MO
207R00000X
Internal Medicine Physician
R-9673
IA
Other
Enumeration date
05/22/2013
Last updated
09/14/2022
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