Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 50178 | AZ |
Y | 208600000X | Surgeon | 50178 | AZ |
N | 2082S0105X | Plastic Hand Surgeon | 50178 | AZ |
N | 2086S0122X | Plastic and Reconstructive Surgery | 50178 | AZ |
NPI | 1821259722 |
---|---|
Provider Name | Dr. David Alexander Kelly |
First Address | Scottsdale, AZ 85260-3696 |
Second Address | Scottsdale, AZ 85260-3696 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2008 |
Last Update Date | 20/09/2019 |