Individual
DR. ERNEST KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
(318) 473-0010
(318) 473-1435
Mailing address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
(318) 473-0010
(318) 473-1435
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
016942
LA
208000000X
Pediatrics Physician
016942
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1340146
—
LA
Enumeration date
09/26/2006
Last updated
04/26/2016
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