Individual
GAIL JOSLIN KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
5101 MAKO DR, WILMINGTON, NC 28409-3203
(937) 726-6260
Mailing address
5101 MAKO DR, WILMINGTON, NC 28409-3203
(937) 726-6260
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2157
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09300
BLUE CROSS BLUE SHIELD
NC
05
—
5914224
—
NC
01
—
P00906668
RAILROAD MEDICARE
NC
Enumeration date
10/29/2009
Last updated
03/17/2018
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