Individual
DR. RALPH ZANE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
77 W FOREST AVE STE 206, FLAGSTAFF, AZ 86001-1483
(239) 980-4302
(928) 773-2598
Mailing address
PO BOX 600, TUBA CITY, AZ 86045-0600
(928) 283-2501
(928) 283-2677
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
005754
AZ
208600000X
Surgery Physician
DO1481
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538369384
UHC
AZ
01
—
3218514
CIGNA
AZ
05
—
540447
—
AZ
Enumeration date
07/20/2007
Last updated
04/06/2020
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