Derek M Kelly
Pediatric Orthopaedic Surgeon
1458 W Poplar Ave Suite 100
Collierville
, Tennessee 38017-0630
Derek M Kelly
Pediatric Orthopaedic Surgeon
1458 W Poplar Ave Suite 100
Collierville
, Tennessee 38017-0630
(901) 759-3196
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About
Features
Specialties
- Pediatric Orthopaedic Surgeon
Languages spoken
- English
Location
First Address
- Derek M Kelly
- 1400 S Germantown Rd
- Germantown, TN
- Zip : 38138-2205
- Fax : (901) 759-3196
- Phone : (901) 759-3100
Second Address
- Derek M Kelly
- 1458 W Poplar Ave Suite 100
- Collierville, TN
- Zip : 38017-0630
- Fax : (901) 759-3196
- Phone : (901) 759-3100
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 43223 | TN |
National Provider Identifier
| NPI | 1649499971 |
|---|---|
| Provider Name | Derek M Kelly |
| First Address | Germantown, TN 38138-2205 |
| Second Address | Collierville, TN 38017-0630 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/04/2007 |
| Last Update Date | 01/05/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 04951036 | (05) | MS |
| 1508536 | (05) | TN |
| 174871001 | (05) | AR |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.