Organization
KELLY MEDICAL, PC
Active
Other names
Kelly Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN BLAKE KELLY MD (DOCTOR)
(405) 752-9600
Entity
Organization
Contact information
Practice address
13921 N MERIDIAN AVE STE 100, OKLAHOMA CITY, OK 73134-1106
(405) 752-9600
(405) 752-9650
Mailing address
PO BOX 268938, OKLAHOMA CITY, OK 73126-8938
(405) 752-9600
(405) 752-9650
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
06/13/2006
Last updated
10/31/2019
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