Individual
DR. FREDERICK WAYNE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
310 W GRAND AVE, RAINBOW CITY, AL 35906-3236
(256) 459-5132
(256) 459-5179
Mailing address
310 W GRAND AVE, RAINBOW CITY, AL 35906-3236
(256) 459-5132
(256) 459-5179
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17437
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051523084
BLUE CROSS
—
05
—
051523084
—
AL
01
—
P00147324
RAILROAD MCARE
—
Enumeration date
06/20/2006
Last updated
09/10/2025
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