Individual
MR. OWEN L KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 N PHOENIX AVE, RUSSELLVILLE, AR 72801-2844
(479) 890-5355
(479) 890-5366
Mailing address
PO BOX 690, RUSSELLVILLE, AR 72811-1146
(479) 890-5355
(479) 890-5366
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
E3477
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182582002
—
AR
Enumeration date
03/21/2006
Last updated
08/22/2023
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