Individual
TED MARTIN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 15TH ST NW, NORTON, VA 24273-1616
(276) 679-9645
(276) 679-9762
Mailing address
96 15TH ST NW, 104, NORTON, VA 24273-1620
(276) 679-8890
(276) 679-9740
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101240536
VA
207R00000X
Internal Medicine Physician
G67501
CA
Other
Enumeration date
09/14/2006
Last updated
07/08/2007
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