Individual
DR. KEVIN M KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
310 GREENVIEW WAY, BOWLING GREEN, KY 42103-8767
(270) 781-3722
(270) 781-3722
Mailing address
310 GREENVIEW WAY, BOWLING GREEN, KY 42103-8767
(270) 781-3722
(270) 781-3722
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
37656
KY
207R00000X
Internal Medicine Physician
37656
KY
208000000X
Pediatrics Physician
37656
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65937252
—
KY
05
—
KO78350
—
KY
Enumeration date
06/27/2006
Last updated
10/30/2019
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