Organization
RICHARD A KELLY MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD ALLEN KELLY MD (PRESIDENT)
(662) 349-2251
Entity
Organization
Contact information
Practice address
210 GOODMAN RD E, SOUTHAVEN, MS 38671-9520
(662) 349-2251
Mailing address
210 GOODMAN RD E, SOUTHAVEN, MS 38671-9520
(662) 349-2251
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MS11375
MS
Other
Enumeration date
11/16/2007
Last updated
11/16/2007
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