Kelly, Daniel R

Kelly, Daniel R is an individual health care provider with primary practice located at 701 Randolph St Ste 120 , Radford VA 24141-3047. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kelly, Daniel R can be contacted via phone (540) 731-3200.

Contact Information

Primary practice address
701 Randolph St Ste 120 Radford VA 24141-3047
Phone: (540) 731-3200
Fax: (540) 639-1048
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101-039704 Virginia

Profile Details

NPI number 1922089556
LBN Legal business name Kelly, Daniel R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2005
Last updated Aug 12th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922089556 NPPES
Virginia MEDICAID 010299268
Virginia MEDICAID 5623502

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