Individual
DAVID WAYNE KELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, DEPT. OF EMERGENCY MEDICINE, JACKSON, MS 39216-4500
(601) 984-5582
Mailing address
360 HERITAGE PL, JACKSON, MS 39212-5825
(773) 793-8118
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036-124819
IL
207P00000X
Emergency Medicine Physician
21214
MS
207P00000X
Emergency Medicine Physician
Primary
688-L
MS
Other
Enumeration date
07/06/2007
Last updated
11/23/2010
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