Individual
DR. THOMAS C KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7001 ROGERS AVE, FORT SMITH, AR 72903-4073
(479) 274-5100
(479) 274-5179
Mailing address
PO BOX 3528, FORT SMITH, AR 72913-3528
(479) 274-2000
(479) 274-2194
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
R-3264
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020009996
RR MEDICARE
—
05
—
105887001
—
AR
Enumeration date
07/19/2006
Last updated
08/28/2015
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