Individual
KELLY J AIREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4851 BROOKVIEW CT, BETTENDORF, IA 52722
(563) 499-1341
Mailing address
4851 BROOKVIEW CT, BETTENDORF, IA 52722-5333
(563) 499-1341
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
19933
NE
207RC0001X
Clinical Cardiac Electrophysiology Physician
30852
IA
207RC0001X
Clinical Cardiac Electrophysiology Physician
9016
SD
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
MD-30852
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07105
BCBS
NE
05
—
200311060A
—
KS
01
—
247400017
IA MEDICARE
IA
05
—
470780857 23
—
NE
01
—
76-00007
UHC
NE
01
—
P00250440
RAILROAD MEDICARE
—
Enumeration date
07/17/2006
Last updated
04/04/2023
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