Individual
MR. MICHAEL JOSEPH KELLY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6585 S YALE AVE STE 720, TULSA, OK 74136-8320
(918) 502-5930
(918) 502-5935
Mailing address
6600 S YALE AVE STE 1200, TULSA, OK 74136-3361
(918) 488-6653
(918) 488-6098
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4618
OK
363AS0400X
Surgical Physician Assistant
2567
CO
Other
Enumeration date
10/28/2006
Last updated
09/22/2021
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