Individual
DR. JAMES B KELLY JR.
Active
Individual
DR. JAMES B KELLY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
100504
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000331
MO FHP PROVIDER NUMBER
MO
01
—
050088896
MO RR MEDICARE NUMBER
MO
05
—
100132430C
—
MO
01
—
18270092
MO BCBS PROVIDER NUMBER
MO
05
—
203317052
—
MO
Enumeration date
05/19/2006
Last updated
12/13/2013
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