Individual
DR. MICHAEL BRYANT KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 PLEASANT VALLEY RD STE 202, OWENSBORO, KY 42303
(270) 417-7500
(270) 417-7509
Mailing address
PO BOX 23229, OWENSBORO, KY 42304-3229
(270) 691-8070
(270) 691-8026
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
52292
KY
207RC0000X
Cardiovascular Disease Physician
60212959
WA
207RC0000X
Cardiovascular Disease Physician
MD43981
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
KY
Enumeration date
12/18/2006
Last updated
05/30/2019
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