Individual
DR. KEVIN J KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4689 FULTON DR NW, CANTON, OH 44718-2379
(330) 649-9400
(330) 649-8059
Mailing address
4689 FULTON DR NW, CANTON, OH 44718-2379
(330) 649-9400
(330) 649-8059
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
KE4069601
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2313740
—
OH
Enumeration date
06/23/2005
Last updated
07/27/2010
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