Organization
KELL MEDICAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT E KELL M.D. (PRIMARY DOCTOR)
(910) 353-1499
Entity
Organization
Contact information
Practice address
200 DOCTORS DR STE F, JACKSONVILLE, NC 28546-6308
(910) 353-1499
(910) 355-0404
Mailing address
200 DOCTORS DR STE F, JACKSONVILLE, NC 28546-6308
(910) 353-1499
(910) 355-0404
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
9600132
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48308
BLUE CROSS BLUE SHIELD
NC
Enumeration date
06/18/2008
Last updated
11/17/2022
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