Individual
DR. TIMOTHY JOHN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2460 N IH 35 E STE 215, WAXAHACHIE, TX 75165-5271
(469) 800-9830
Mailing address
2460 N IH 35 E STE 215, WAXAHACHIE, TX 75165-5271
(469) 800-9830
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
S7696
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2014
Last updated
10/12/2020
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