Individual
MARK C KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1300 SUNSET DR, SUITE A, GRENADA, MS 38901-4086
(662) 227-4463
(662) 226-5257
Mailing address
1300 SUNSET DR, SUITE A, GRENADA, MS 38901-4086
(662) 227-4463
(662) 226-5257
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
16693
MS
Other
Enumeration date
05/26/2006
Last updated
04/15/2008
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