Individual
DR. SHANE E KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4117 E EMORY RD, KNOXVILLE, TN 37938-4229
(865) 922-2121
(865) 922-0006
Mailing address
1275 DICK LONAS RD UNIT 101, KNOXVILLE, TN 37909-1383
(865) 584-4747
(865) 584-1363
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
49860
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q000692
—
TN
Enumeration date
07/09/2010
Last updated
03/11/2020
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