Individual
NATHAN KELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-6279
(208) 367-3951
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642
(208) 367-6279
(208) 367-3951
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M-13948
ID
207R00000X
Internal Medicine Physician
R74964
AZ
208M00000X
Hospitalist Physician
Primary
M-13948
ID
Other
Enumeration date
05/13/2015
Last updated
08/01/2018
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