Individual
DR. JOHN BARRY KELLY SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3125 DR RUSSELL SMITH WAY, CARTHAGE, MO 64836-7402
(417) 358-8121
Mailing address
5231 SAND ROCK RD, LA GRANGE, TX 78945-4149
(417) 499-3908
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
R7559
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972815181
—
MO
Enumeration date
07/06/2010
Last updated
02/18/2014
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