Individual
DR. RONAN J KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3410 WORTH ST STE 400, DALLAS, TX 75246-2092
(214) 370-1000
(214) 370-1986
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-2987
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R8922
TX
207RX0202X
Medical Oncology Physician
D72295
MD
207RX0202X
Medical Oncology Physician
Primary
R8922
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048473300
—
MD
05
—
392921801
—
TX
Enumeration date
05/19/2011
Last updated
12/07/2021
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