Douglas Wayne Kelly
Sports Medicine Orthopaedic Surgeon
5501 N 19th Ave 432
Phoenix
, Arizona 85015-2450
Douglas Wayne Kelly
Sports Medicine Orthopaedic Surgeon
5501 N 19th Ave 432
Phoenix
, Arizona 85015-2450
(602) 242-7265
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About
Features
Specialties
- Sports Medicine Orthopaedic Surgeon
Languages spoken
- English
Location
First Address
- Douglas Wayne Kelly
- 5501 N 19th Ave 432
- Phoenix, AZ
- Zip : 85015-2450
- Fax : (602) 242-7265
- Phone : (602) 242-7691
Second Address
- Douglas Wayne Kelly
- 5501 N 19th Ave 432
- Phoenix, AZ
- Zip : 85015-2450
- Fax : (602) 242-7265
- Phone : (602) 242-7691
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What type of doctor is Douglas Wayne Kelly
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 12896 | AZ |
National Provider Identifier
| NPI | 1104924158 |
|---|---|
| Provider Name | Douglas Wayne Kelly |
| First Address | Phoenix, AZ 85015-2450 |
| Second Address | Phoenix, AZ 85015-2450 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/09/2006 |
| Last Update Date | 08/07/2007 |
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.