Individual
KELLEN JAMES GLYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-2277
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-2277
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
0101276029
VA
208D00000X
General Practice Physician
0101276029
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S069-130-009-815
DRIVER'S LICENSE
MN
Enumeration date
02/28/2021
Last updated
03/02/2026
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