Individual
MR. JOHN PAUL KELLEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1130 ANNAPOLIS RD STE 100, ODENTON, MD 21113-1622
(410) 672-2255
Mailing address
23555 BROWN RD, HOLLYWOOD, MD 20636-3232
(240) 434-6104
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0007181
MD
Other
Enumeration date
05/07/2019
Last updated
05/07/2019
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