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1104924158
DOUGLAS WAYNE KELLY
PHOENIX, AZ
NPI
1104924158
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207XX0005X Orthopaedic Surgery Sports Medicine
(Licence: AZ 12896)
Enumeration Date
2006-09-20
Last Update Date
2007-07-08
Business Address
DOUGLAS WAYNE KELLY M.D.
5501 N 19TH AVE 432
PHOENIX, AZ 85015-2450
Phone number: 602-242-7691
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Mailing Address
DOUGLAS WAYNE KELLY M.D.
5501 N 19TH AVE 432
PHOENIX, AZ 85015-2450
Phone number: 602-242-7691
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