Individual
COLIN KENNETH KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
BUREAU OF MEDICINE & SURGERY DETACHMENT, NAS JACKSONVILLE, BUILDING 554, JACKSONVILLE, FL 32212
(843) 794-6994
Mailing address
BUREAU OF MEDICINE & SURGERY DETACHMENT, NAS JACKSONVILLE, BUILDING 554, JACKSONVILLE, FL 32212
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
0101264704
VA
Other
Enumeration date
06/16/2016
Last updated
07/10/2024
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