Individual
DR. RAY DON KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3066 E MERIDIAN PARK LOOP, WASILLA, AK 99654-7299
(907) 357-9590
Mailing address
3066 E MERIDIAN PARK LOOP, WASILLA, AK 99654-7299
(907) 357-9590
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4001
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD9831
—
AK
Enumeration date
01/26/2006
Last updated
10/13/2011
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