Individual
WILLIAM R KELLEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9330 STATE ROAD 54, TRINITY, FL 34655-1808
(904) 399-5800
Mailing address
4825 HWY 95, FORT MOHAVE, AZ 86426-8315
(760) 326-7225
(760) 326-8867
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
159835
FL
2085R0202X
Diagnostic Radiology Physician
27770
AZ
2085R0202X
Diagnostic Radiology Physician
C51795
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C517950
—
CA
05
—
100505339
—
NV
05
—
914673
—
AZ
Enumeration date
11/16/2005
Last updated
05/22/2023
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