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Individual

MR. JOHN P KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1535 MEDICAL PKWY, STE B, CARSON CITY, NV 89703-4654
(775) 445-7960
(775) 883-3395
Mailing address
PO BOX 4540, CARSON CITY, NV 89702-4540
(775) 882-0430
(775) 852-6902

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
NV6376
NV
207RX0202X
Medical Oncology Physician
6376
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002013294
NV
01
6376
MEDICAL LICENSE
NV
Enumeration date
03/21/2006
Last updated
09/18/2014
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