Individual
DR. MICHAEL EDWARD KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9430 PARK WEST BLVD STE 310, KNOXVILLE, TN 37923-4203
(865) 690-5263
(865) 588-3740
Mailing address
PO BOX 52948, KNOXVILLE, TN 37950-2948
(865) 306-5675
(865) 584-7712
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD34159
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3896741
—
TN
Enumeration date
08/24/2006
Last updated
10/10/2013
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