Individual
DOUGLAS CRAIG KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
225 CLEARFIELD AVE, VIRGINIA BEACH, VA 23462-1815
(757) 457-5100
(757) 961-3696
Mailing address
225 CLEARFIELD AVE, VIRGINIA BEACH, VA 23462-1815
(757) 457-5100
(757) 961-3696
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0101257567
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568605244
—
VA
Enumeration date
04/11/2009
Last updated
01/17/2017
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