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Individual

CHARLES E KELLY II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2839 HWY 231 NORTH, SUITE 208A, SHELBYVILLE, TN 37160-7449
(931) 685-8783
(931) 685-8784
Mailing address
2839 HWY 231 NORTH, SUITE 208A, SHELBYVILLE, TN 37160-7449
(931) 685-8783
(931) 685-8784

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
40151
TN
207RG0100X
Gastroenterology Physician
Primary
40151
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3334724
TN
Enumeration date
09/02/2005
Last updated
03/13/2009
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