Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | J3511 | TX |
NPI | 1013957398 |
---|---|
Provider Name | Dr. Donald Kyle Kelley |
First Address | Austin, TX 78705-1006 |
Second Address | Austin, TX 78705-1006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 08/07/2007 |