Organization
BRIAN W KELLY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOANNE ELAINE JOHNSON (ACCOUNTS RECEIVABLE BOOKKEEPER)
(503) 640-5950
Entity
Organization
Contact information
Practice address
545 SE OAK ST, SUITE F, HILLSBORO, OR 97123-4147
(503) 640-5950
(503) 648-3140
Mailing address
545 SE OAK ST, SUITE F, HILLSBORO, OR 97123-4147
(503) 640-5950
(503) 648-3140
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MD10756
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213070
—
OR
01
—
DG4207
GBA RAILROAD MEDICARE
OR
Enumeration date
12/21/2007
Last updated
02/12/2010
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