Individual
DR. MATTHEW J KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1114 HICKOX ST, SANTA FE, NM 87505-1088
(505) 982-9961
Mailing address
1114 HICKOX ST, SANTA FE, NM 87505-1088
(505) 982-9961
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
72-167
NM
Other
Enumeration date
11/22/2006
Last updated
08/02/2007
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