Individual
DR. RICHARD ALLEN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
210 GOODMAN RD E, SOUTHAVEN, MS 38671-9520
(662) 349-2251
(662) 349-2602
Mailing address
210 GOODMAN RD E, SOUTHAVEN, MS 38671-9520
(662) 349-2251
(662) 349-2602
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11375
MS
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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